血清TLR4、IgG4在类风湿性关节炎患者中的表达及临床意义  

Expression and clinical significance of serum TLR4 and IgG4 in patients with rheumatoid arthritis

作　　者：封欣然 张小艳 金玉梁 杨琴 FENG Xinran;ZHANG Xiaoyan;JIN Yuliang;YANG Qin(Department of Clinical Laboratory,Nanchang People's Hospital(Nanchang Third Hospital),Nanchang,Jiangxi 330008,China)

机构地区：[1]南昌市人民医院(南昌市第三医院)检验科,江西南昌330008

出　　处：《国际检验医学杂志》2024年第S02期20-24,共5页International Journal of Laboratory Medicine

基　　金：南昌市科技支撑计划项目洪科字(2020)133号第15项。

摘　　要：目的探讨血清Toll样受体4(TLR4)、免疫球蛋白G4(IgG4)在类风湿性关节炎(RA)患者中的表达及临床意义。方法选取2022年7月至2023年6月该院收治的150例RA患者作为RA组,另选取同期接受体检的60例健康者作为对照组,所有受试者均接受血清TLR4、IgG4检测,比较两组血清TLR4、IgG4水平,并分析不同病情活动性患者的指标差异,统计预后情况,进行单因素与多因素Logistic回归分析,采用受试者工作特征曲线(ROC)评估预测价值。结果RA组血清TLR4、IgG4水平较对照组更高(P<0.05);活动期患者的血清TLR4、IgG4水平较稳定期患者更高(P<0.05);150例RA患者中,预后不良34例,预后良好116例;预后不良组病程较预后良好组更长(P<0.05),血清TLR4、IgG4水平更高(P<0.05);多因素Logistic回归分析结果显示,TLR4(OR=4.791)、IgG4(OR=6.362)是影响RA预后的独立危险因素(P<0.05);绘制ROC曲线显示,血清TLR4、IgG4、联合检测预测RA预后的曲线下面积(AUC)分别为0.795、0.838、0.940。结论RA患者的血清TLR4、IgG4呈高表达,且指标水平受到病情活动性影响,可用于预测患者预后,联合检测时的预测价值较高。Objective To investigate the expression and clinical significance of serum Toll like receptor 4(TLR4)and immunoglobulin G4(IgG4)in patients with rheumatoid arthritis(RA).Methods A total of 150 RA patients admitted to Nanchang People's Hospital from July 2022 to June 2023 were selected as the RA group,and 60 healthy individuals who underwent physical examinations during the same period were selected as the control group.All subjects underwent serum TLR4 and IgG4 testing.The levels of TLR4 and IgG4 in the two groups were compared,and the differences in indicators between patients with different disease activity were analyzed.The prognosis was statistically analyzed,and univariate and multivariate Logistic regression analyses were conducted.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value.Results The serum levels of TLR4 and IgG4 in the RA group were higher than those in the control group(P<0.05).The serum levels of TLR4 and IgG4 in active patients were higher than those in stable patients(P<0.05).Among 150 RA patients,34 had poor prognosis and 116 had good prognosis.The poor prognosis group had a longer course of illness than the good prognosis group(P<0.05),and higher levels of serum TLR4 and IgG4(P<0.05).The results of multivariate Logistic regression analysis showed that TLR4(OR=4.791)and IgG4(OR=6.362)were independent risk factors affecting the prognosis of RA(P<0.05).The ROC curve showed that the areas under the curve(AUC)for predicting RA prognosis using serum TLR4,IgG4,and combined detection were 0.795,0.838,and 0.940,respectively.Conclusion Serum TLR4 and IgG4 are highly expressed in RA patients,and their levels are affected by disease activity,which can be used to predict patient prognosis.Combined detection has high predictive value.

关 键 词：血清Toll样受体4 免疫球蛋白G4 类风湿性关节炎 临床意义 

分 类 号：R593.22[医药卫生—内科学] R446.1[医药卫生—临床医学]