血清sST2、sPD-1对老年类风湿关节炎患者预后的预测价值  

Predictive value of serum sST2 and sPD-1 in the prognosis of elderly patients with rheumatoid arthritis

作　　者：成强 张瑶 李璟佳 李华[2] CHENG Qiang;ZHANG Yao;LI Jingjia;LI Hua(The Second Department of Health Care,971 Hospital of PLA Navy,Qingdao,Shandong 266071,China;Department of Rheumatology and Immunology,Affiliated Hospital of Qingdao University,Qingdao,Shandong 266555,China)

机构地区：[1]中国人民解放军海军第九七一医院保健二科,山东青岛266071 [2]青岛大学附属医院风湿免疫科,山东青岛266555

出　　处：《检验医学与临床》2025年第3期320-324,共5页Laboratory Medicine and Clinic

基　　金：山东省青岛市医药卫生科研计划项目(2022-WJZD216)。

摘　　要：目的探究血清可溶性基质裂解素2(sST2)、可溶性程序性死亡受体-1(sPD-1)对老年类风湿关节炎(RA)患者预后的预测价值。方法选取2022年1月至2023年1月中国人民解放军海军第九七一医院收治的110例老年RA患者作为观察组,另选取110例同期在中国人民解放军海军第九七一医院进行健康体检的健康者作为对照组。根据患者预后情况将患者分为预后不良与预后良好组。比较观察组与对照组、预后良好组与预后不良组血清sST2、sPD-1水平。采用多因素Logistic回归分析RA患者预后不良的影响因素。绘制受试者工作特征(ROC)曲线分析血清sST2、sPD-1单独及联合对RA患者预后不良的预测价值。结果观察组血清sST2、sPD-1水平均高于对照组,差异均有统计学意义(P<0.05)。预后不良组33例,预后良好组77例。预后不良组患者病程长于预后良好组,差异有统计学意义(P<0.05)。预后不良组血清sST2、sPD-1水平均高于预后良好组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,sST2、sPD-1、病程均为RA患者预后不良的影响因素(P<0.05)。ROC曲线分析结果显示,血清sST2、sPD-1单独预测RA患者预后不良的曲线下面积(AUC)分别为0.777(95%CI:0.688~0.851)、0.800(95%CI:0.713~0.870),二者联合预测的AUC为0.872(95%CI:0.795~0.928),二者联合预测优于单独预测(Z_(二者联合-sST2)=2.006、Z_(二者联合-sPD-1)=2.001,P=0.045、0.045),二者联合预测的灵敏度为90.91%,特异度为76.62%。结论老年RA患者血清sST2、sPD-1水平均上调,且均为RA患者预后不良的影响因素,二者联合对RA患者预后不良具有更高的预测价值。Objective To investigate the predictive value of serum soluble stromelysin 2(sST2)and soluble programmed death-1(sPD-1)in the prognosis of elderly patients with rheumatoid arthritis(RA).Methods A total of 110 elderly RA patients admitted to the 971 Hospital of the PLA Navy from January 2022 to January 2023 were selected as the observation group,and 110 healthy people who underwent physical examination in the 971 Hospital of the PLA Navy during the same period were selected as the control group.According to the prognosis,the patients were divided into poor prognosis group and good prognosis group.The serum levels of sST2 and sPD-1 were compared between the observation group and the control group,and between the good prognosis group and the poor prognosis group.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in RA patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum sST2 and sPD-1 levels alone and in combination for poor prognosis in RA patients.Results The serum levels of sST2 and sPD-1 in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were 33 cases in the poor prognosis group and 77 cases in the good prognosis group.The course of disease in the poor prognosis group was longer than that in the good prognosis group,and the difference was statistically significant(P<0.05).The serum levels of sST2 and sPD-1 in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that sST2,sPD-1 and disease duration were the influencing factors of poor prognosis in RA patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum sST2 and sPD-1 levels for predicting poor prognosis of RA patients was 0.777(95%CI:0.688-0.851)and 0.800(95%CI:0.713-0.870)respectively,and the AUC of combined prediction was 0.8

关 键 词：老年 类风湿关节炎 可溶性基质裂解素2 可溶性程序性死亡受体-1 预后 

分 类 号：R593.22[医药卫生—内科学]