血清JAK-STAT信号通路相关蛋白对类风湿性关节炎患者的预后评估  

Serum JAK-STAT signaling pathway related proteins assessment of prognosis in patients with rheumatoid arthritis

作　　者：张雪锋 吕艳艳 戴璐 Zhang Xuefeng;Lyu Yanyan;Dai Lu(Department of Osteoporosis,Shaanxi Integrated Traditional Chinese and Western Medicine Hospital,Xi'an Fifth Hospital,Xi'an 710082,China;Department of Rheumatology and Immunology,Shaanxi Integrated Traditional Chinese and Western Medicine Hospital,Xi'an Fifth Hospital,Xi'an 710082,China;Department of Rheumatology,Immunology,and Osteoporosis,Shaanxi Integrated Traditional Chinese and Western Medicine Hospital,Xi'an Fifth Hospital,Xi'an 710082,China)

机构地区：[1]陕西省中西医结合医院、西安市第五医院骨质疏松科,西安710082 [2]陕西省中西医结合医院、西安市第五医院风湿免疫科,西安710082 [3]陕西省中西医结合医院、西安市第五医院风湿免疫骨松科,西安710082

出　　处：《国际医药卫生导报》2025年第6期960-964,共5页International Medicine and Health Guidance News

基　　金：陕西省自然科学基础研究计划(2023-JC-YB-765)。

摘　　要：目的探讨血清中Janus激酶(janus kinase,JAK)-转录活化因子(signal transducer and activator of transcription,STAT)信号通路相关蛋白在类风湿性关节炎患者预后评估中的价值。方法研究对象为陕西省中西医结合医院于2022年1月至2024年1月收治的类风湿性关节炎患者,共纳入118例,所有患者均在入组后检测血清JAK-STAT信号通路相关蛋白JAK、STAT3的表达量及炎性因子水平[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6、巨噬细胞移动抑制因子(MIF)]。给予甲氨蝶呤和醋酸泼尼松治疗4周后,根据患者病情缓解情况分为预后良好组和预后不良组。预后良好组中男49例、女34例,年龄(38.45±4.72)岁;预后不良组中男22例、女14例,年龄(38.73±4.88)岁。比较两组各检测指标水平,通过logistic回归分析筛选预后不良的风险因素,并采用受试者操作特征曲线(ROC)评估血清JAK、STAT3表达水平对类风湿性关节炎预后的诊断价值,采用t、χ^(2)检验进行统计学比较。结果118例类风湿性关节炎患者中,预后不良35例(29.66%)。预后不良组治疗前的血清JAK、STAT3 mRNA水平分别为1.61±0.35、1.55±0.34,高于预后良好组(1.34±0.28、1.30±0.26),差异均有统计学意义(均P<0.05)。预后不良组治疗前的TNF-α、IL-1β、IL-6、MIF分别为(65.82±7.13、20.17±3.42、28.56±4.02、20.39±3.15)μg/L,均高于预后良好组[(58.42±6.36、15.24±2.39、23.30±3.19、16.42±2.48)μg/L],差异均有统计学意义(均P<0.05)。Logistic回归分析显示,治疗前JAK、STAT3 mRNA和炎性因子水平均是影响预后的重要因素(均P<0.05)。ROC显示,JAK联合STAT3预测类风湿性关节炎患者预后不良的曲线下面积为0.809。结论JAK-STAT信号通路在类风湿性关节炎中起重要作用,影响治疗效果和预后。Objective To explore the value of serum Janus kinase(JAK)and signal transducer and activator of transcription(STAT)signaling pathway markers in the assessment of the prognosis in patients with rheumatoid arthritis.Methods From January 2022 to January 2024,118 patients with rheumatoid arthritis treated at Shaanxi Integrated Traditional Chinese and Western Medicine Hospital were enrolled.After the enrollment,the serum levels of JAK and STAT3 proteins and the levels of inflammatory markers[tumor necrosis factor-alpha(TNF-α),interleukin-1 beta(IL-1β),IL-6,and macrophage migration inhibitory factor(MIF)]were measured.The patients were treated with methotrexate and prednisone acetate for 4 weeks,and their conditions was evaluated.Based on the improvement in symptoms,the patients were categorized into a good prognosis group and a poor prognosis group.There were 49 males and 34 females in the good prognosis group;they were(38.45±4.72)years old.There were 22 males and 14 females in the poor prognosis group;they were(38.73±4.88)years old.The levels of the markers were compared between the two groups.The logistic regression analysis was used to identify the risk factors for poor prognosis.The diagnostic value of serum JAK and STAT3 expression levels for predicting outcomes was assessed using the receiver operating characteristic curve(ROC).t andχ^(2) tests were used for the statistical analysis.Results Among the 118 patients,35(29.66%)had poor prognosis.Before the treatment,the serum levels of JAK and STAT3 in the poor prognosis group were higher than those in the good prognosis group(1.61±0.35 vs.1.34±0.28 and 1.55±0.34 vs.1.30±0.26),with statistical differences(both P<0.05).The levels of TNF-α,IL-1β,IL-6,and MIF in the poor prognosis group before the treatment were higher than those in the good prognosis group[(65.82±7.13)μg/L vs.(58.42±6.36)μg/L,(20.17±3.42)μg/L vs.(15.24±2.39)μg/L,(28.56±4.02)μg/L vs.(23.30±3.19)μg/L,and(20.39±3.15)μg/L vs.(16.42±2.48)μg/L],with statistical differences(all P<0

关 键 词：JAK-STAT信号通路 类风湿性关节炎 预后 

分 类 号：R73[医药卫生—肿瘤]