类风湿关节炎患者血清钙卫蛋白的表达变化及临床价值  

A Study of Expression Changes and Clinical Significance of Serum Calprotectin in Patients with Rheumatoid Arthritis

作　　者：李玉麒 黄梅[2] 王子铭 丁海 虞伟[2] 姚根宏[1] LI Yuqi;HUANG Mei;WANG Ziming;DING Hai;YU Wei;YAO Genhong(Department of Rheumatology and Immunology,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008,China;Department of Clinical Laboratory,Affiliated Taikang Xianlin Drum Tower Hospital,MedicalSchool of Nanjing University,Nanjing 210046,China;Department of Clinical Laboratory,Nanjing Drum TowerHospital Clinical College of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学鼓楼临床医学院风湿免疫科,江苏南京210008 [2]南京大学医学院附属泰康仙林鼓楼医院检验科,江苏南京210046 [3]南京医科大学鼓楼临床医学院检验科,江苏南京210008

出　　处：《标记免疫分析与临床》2024年第10期1842-1846,1918,共6页Labeled Immunoassays and Clinical Medicine

基　　金：南京市卫生科技发展专项资金项目(编号:YKK20225);南京大学医学院附属泰康仙林鼓楼医院基金项目(编号:TKKYZD20211610)。

摘　　要：目的检测类风湿关节炎(RA)患者血清中钙卫蛋白(CALP)的水平,分析其与患者炎症参数的相关性,探讨其在RA的临床诊断中的价值。方法RA患者54例(疾病组)、其他自身免疫病患者45例(疾病对照组)、健康体检者41例(健康对照组)。收集3组受试者的血清,采用酶联免疫吸附法测定和比较各组血清中CALP水平;比较各组血清RF、IgA、IgG、IgM、IgE、C3、C4、ALB、CRP和全血Hb水平;分析CALP与这些检测指标及疾病活动评分-28(DAS-28)的相关性。结果与健康对照者和非RA患者比较,RA患者的CALP、RF、CRP、补体C3、补体C4水平显著升高(P<0.05);但是3组之间的IgA、IgG、IgM、IgE血清水平差异无统计学意义(P>0.05);RA组和非RA患者的Hb、ALB水平明显低于HC组(P<0.05);CALP与ALB呈负相关,与C3、C4、RF、CRP、DAS-28评分呈正相关,与IgA、IgG、IgM、Hb、IgE无明显相关性;以血清RF、CRP、CALP以及3项联合的结果绘制ROC曲线,AUC分别为0.807、0.782、0.761及0.895,3者联合检测优于各项独立诊断(Z_(CALP-联合检测)=3.533,P=0.0004;Z_(CRP-联合检测)=3.015,P=0.0026;Z_(RF-联合检测)=2.260,P=0.0239)。结论RA患者血清CALP增高,CALP与其他指标联合使用对RA病情判断具有一定的指导作用,有望成为RA诊断的新的生物学标志物。Objective The level of serum calprotectin(CALP)in patients with rheumatoid arthritis(RA)was detected,and its correlation with inflammatory parameters was evaluated,aiming to explore its potential clinical diagnostic value for RA.Methods A total of 54 RA patients(disease group),45 patients with other autoimmune diseases(disease control group),and 41 healthy individuals undergoing physical examinations(healthy control group)were enrolled in our study.The serum samples were collected from all patients and healthy individuals.The levels of serum CALP were detected by ELISA.The comparative analysis of serum CALP among different groups were performed with ANOVA test and correlations of CALP with RF,IgA,IgG,IgM,IgE,C3,C4,ALB,CRP,blood Hb and DAS-28 score were evaluated by multiple linear regression method.Results Compared with the healthy control group and disease control group,the concentrations of CALP,RF,CRP,complement C3,and complement C4 in the serum of RA patients were significantly increased(P<0.05).However,there was no significant difference in the concentrations of IgA,IgG,IgM and IgE among these three groups(P>0.05).Compared with HC group,the levels of Hb and serum ALB in the RA group and disease control group were significantly decreased(P<0.05).Spearman correlation analysis showed that the levels of CALP in serum were significantly negatively correlated with that of ALB,while positively correlated with that of C3,C4,RF,CRP and DAS-28 score,but not significantly correlated with IgA,IgG,IgM,and Hb.ROC curves showed that AUCs of serum RF,CRP,CALP and their combination for screening the patients with RA were 0.807,0.782,0.761 and 0.895,respectively.Compared with their individual diagnosis,the AUC of their combination was significantly better(Z_(combination-CALP)=3.533,P=0.0004;Z_(combination-CRP)=3.015,P=0.0026;Z_(combination-RF)=2.260,P=0.0239).Conclusion Serum CALP is elevated in patients with rheumatoid arthritis(RA),and the combined application of CALP with other indicators has a significant guiding value in

关 键 词：类风湿关节炎 钙卫蛋白 生物学标志物 

分 类 号：R593.22[医药卫生—内科学]