血清骨桥蛋白在类风湿关节炎患者血清中的表达及临床意义  

The expression and clinical significance of serum osteopontin in patients with rheumatoid arthritis

作　　者：江凤林 李飞 邵一佳 王友莲[2] JIANG Fenglin;LI Fei;SHAO Yijia;WANG Youlian(Department of Rheumatology,Jiangxi Provincial People's Hospital,Jiangxi Nanchang,330006,China)

机构地区：[1]南昌市第一医院风湿免疫科 [2]江西省人民医院风湿免疫科,南昌330006

出　　处：《江西医药》2024年第8期715-719,共5页Jiangxi Medical Journal

基　　金：国家自然科学基金,编号81860293;江西省级临床医学研究中心,编号20192BCD42005。

摘　　要：目的探讨骨桥蛋白(OPN)在类风湿关节炎(RA)患者血清中的表达水平及其临床意义。方法选择68例RA患者作为RA组和63例体检的健康者作为对照组,并将RA组分为骨侵蚀组(39例)和非骨侵蚀组(29例)。根据血清抗CCP抗体情况将RA组分为抗CCP抗体阴性组和阳性组。比较各组血清中OPN、β-CTX、DKK-1、PINP水平,用双能X线吸收测定法检测RA组患者骨密度(包括股骨颈、Ward's三角区);收集比较其他数据。结果(1)RA组OPN(41.86±6.92)ng/mL、β-CTX(825.74±152.76)pg/mL、DKK-1(21.00±3.79)ng/mL较对照组[(24.91±5.20)ng/mL、(482.85±103.47)pg/mL、(11.65±1.73)ng/mL]升高,差异有统计学意义(t分别为15.91、15.14、18.38,P<0.05);而RA组PINP(25.59±7.76)ng/mL较对照组[(47.29±7.00)ng/mL,t=-16.76,P<0.05]降低。(2)骨侵蚀组OPN(45.14±6.45)ng/mL、β-CTX(901.65±135.31)pg/mL、DKK-1(22.38±3.57)ng/mL高于非骨侵蚀组[(37.45±4.80)ng/mL、(723.66±110.35)ng/mL、(19.15±3.29)ng/mL],差异有统计学意义(t分别为5.64、5.79、3.81,P=0.000)。骨侵蚀组PINP(23.68±7.44)ng/mL低于非骨侵蚀组[(28.15±7.56)ng/mL,t=-2.43,P=0.018]。(3)RA抗CCP抗体阴性组OPN(45.11±7.07)ng/mL高于正常对照组(24.91±5.20)ng/mL,差异有统计学意义(t=11.00,P=0.000),而与抗CCP抗体阳性组(40.78±6.59)ng/mL相比较差异无统计学意义(t=2.30,P=0.020)。(4)骨侵蚀组的骨密度(包括股骨颈及Ward's三角区)均低于非骨侵蚀组[(0.61±0.11)g/cm^(2)vs(0.67±0.09)g/cm^(2),t=2.28,P=0.030;(0.43±0.12)g/cm^(2)vs(0.54±0.13)g/cm^(2),t=3.76,P=0.000]。(5)相关性分析显示:OPN与DAS28(ESR)、β-CTX、DKK-1呈正相关(r分别为0.30、0.40、0.37,P<0.05),与PINP呈负相关(r=-0.31,P<0.05),与抗CCP抗体无相关性(r=-0.06,P=0.640)。(6)ROC曲线分析提示血清OPN对RA骨侵蚀及疾病活动度均具有较好的预测价值。结论RA患者血清OPN水平较健康组显著升高,以骨侵蚀组升高更为明显。OPN与骨吸收指标及RA疾病活动度指标呈正相关,提示OPN可�Objective To investigate the expression levels and clinical significance of serum osteopontin in patients with rheumatoid arthritis.Methods Sixty-eight patients with RA were selected as the RA group and sixty-three healthy patients who underwent physical examination as the control group,and the RA group was divided into bone erosion group(39 cases)and non-bone erosion group(29 cases).According to the serum anti-Cyclic citrullinated peptideantibody situation,the RA group was divided into anti-CCP antibody negative group and positive group.The levels of OPN,β-CTX,DKK-1,and PINP in the serum of each group were measured by ELISA method,and bone density(including femoral neck and Ward's triangle)in the RA group was measured by dual-energy X-ray absorption assay;other data were collected and compared.Results(1)The level of OPN(41.86±6.92)ng/mL,β-CTX(825.74±152.76)pg/mL,DKK-1(21.00±3.79)ng/mL in the RA group compared with the control group[(24.91±5.20)ng/mL,(482.85±103.47)pg/mL,(11.65±1.73)ng/mL]were raised,and there were statistical differences(t was15.91,15.14,18.38,respectively,P<0.05).But the level of PINP(25.59±7.76)ng/mL in the RA group was lower than that in the control group[(47.29±7.00)ng/mL,t=-16.76,P<0.05].(2)The level of OPN(45.14±6.45)ng/mL,β-CTX(901.65±135.31)pg/mL,DKK-1(22.38±3.57)ng/mL in the bone erosion group compared with the non-bone erosion group[(37.45±4.80)ng/mL,(723.66±110.35)ng/mL,(19.15±3.29)ng/mL]were raised,and there were statistical differences(t was 5.64,5.79,3.81,respectively,P=0.000).The level of PINP(23.68±7.44)ng/mL in the bone erosion group was lower than that in the non-bone erosion group[(28.15±7.56)ng/mL,t=-2.43,P=0.018].(3)RA anti-CCP antibody negative group OPN(45.11±7.07)ng/mL was higher than that of normal control group(24.91±5.20)ng/mL,with a strong statistical difference(t=11.00,P=0.000),but the difference was small compared with the anti-CCP positive group(40.78±6.59)ng/mL(t=2.30,P=0.020).(4)Bone bone density(including femur neck and Ward's triangle)was

关 键 词：类风湿关节炎 骨桥蛋白 骨侵蚀 疾病活动度 

分 类 号：R593.22[医药卫生—内科学]