血清BALP、CX3CL1水平与强直性脊柱炎患者疾病严重程度及预后的关系  

Serum BALP and CX3CL1 levels in relation to disease severity and prognosis in patients with ankylosing spondylitis

作　　者：孟钊志 马验 高海聪 朱文博 寻欢 Meng Zhaozhi;Ma Yan;Gao Haicong;Zhu Wenbo;Xun Huan(Department of Orthopedics,People's Hospital of Tongchuan,Shaanxi,Tongchuan 727007,China;不详)

机构地区：[1]铜川市人民医院骨科,陕西铜川727007 [2]铜川市人民医院脊柱外科,陕西铜川727007

出　　处：《疑难病杂志》2025年第3期338-342,348,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省科技计划项目(2021JM-109)。

摘　　要：目的探讨血清骨特异性碱性磷酸酶(BALP)、C-X3-C基序趋化因子配体1(CX3CL1)水平与强直性脊柱炎(AS)患者疾病严重程度及预后的关系。方法回顾性收集2019年1月-2024年1月铜川市人民医院骨科收治的AS患者153例为AS组。根据病情程度将AS患者分为早期AS亚组41例、中期AS亚组57例、晚期AS亚组55例;根据随访6个月预后情况将AS患者分为不良预后亚组55例和良好预后亚组98例。另选取同期医院健康体检志愿者70例为健康对照组。采用酶联免疫吸附法检测血清BALP、CX3CL1水平;多因素Logistic回归分析AS患者不良预后的影响因素;受试者工作特征(ROC)曲线分析血清BALP、CX3CL1水平对AS患者不良预后的预测价值。结果AS组血清BALP、CX3CL1水平高于健康对照组(t/P=16.275/<0.001、14.357/<0.001);伴随病情加重,早期AS亚组、中期AS亚组、晚期AS亚组AS患者血清BALP、CX3CL1水平依次升高(F/P=79.259/<0.001、84.646/<0.001);随访6个月,153例AS患者不良预后发生率为35.95%(55/153)。不良预后亚组AS患者髋关节受累比例、C反应蛋白(CRP)、红细胞沉降率(ESR)、BALP、CX3CL1水平高于良好预后亚组(t/P=27.546/<0.001、3.943/<0.001、4.020/<0.001、6.245/<0.001、7.012/<0.001);多因素Logistic回归分析显示,髋关节受累、CRP高、ESR高、BALP高、CX3CL1高为AS患者不良预后的独立危险因素[OR(95%CI)=6.641(1.993~22.131)、1.092(1.009~1.182)、1.203(1.089~1.329)、1.039(1.020~1.059)、4.644(2.145~10.056)];血清BALP、CX3CL1水平及二者联合预测AS患者不良预后的曲线下面积(AUC)分别为0.775、0.795、0.873,二者联合的AUC大于血清BALP、CX3CL1水平单独预测的AUC(Z/P=3.355/0.001、2.666/0.008)。结论AS患者血清BALP、CX3CL1水平升高,与疾病严重程度加重和不良预后有关,血清BALP、CX3CL1水平联合对AS患者预后有较高的预测效能。Objective To investigate the relationship between serum bone specific bone specific alkaline phosphatase(BALP),C-X3-C motif chemokine ligand 1(CX3CL1)levels,and disease severity and prognosis in patients with ankylosing spondylitis(AS).Methods Retrospective collected 153 AS patients admitted to the Department of Orthopedics,Tongchuan People's Hospital,from January 2019 to January 2024(AS group).Patients were divided into early-stage AS subgroup(41 cases),mid-stage AS subgroup(57 cases),and late-stage AS subgroup(55 cases)based on disease severity,and into unfavorable prognosis subgroup(55 cases)and favorable prognosis subgroup(98 cases)based on 6-month follow-up outcomes.Seventy healthy volunteers were included as the control group.Serum BALP and CX3CL1 levels were measured using enzyme-linked immunosorbent assay.Multivariate logistic regression was used to analyze factors influencing unfavorable prognosis in AS patients,and receiver operating characteristic(ROC)curves were constructed to evaluate the predictive value of serum BALP and CX3CL1 levels for unfavorable prognosis.Results Serum BALP and CX3CL1 levels were significantly higher in the AS group compared to the control group(t/P=16.275/<0.001,14.357/<0.001).BALP and CX3CL1 levels increased progressively with disease severity across early-stage,mid-stage,and late-stage AS subgroups(F/P=79.259/<0.001,84.646/<0.001).The 6-month unfavorable prognosis rate among AS patients was 35.95%(55/153).Patients with unfavorable prognosis had higher rates of hip joint involvement,CRP,ESR,BALP,and CX3CL1 levels compared to those with favorable prognosis(t/P=27.546/<0.001,3.943/<0.001,4.020/<0.001,6.245/<0.001,7.012/<0.001).Logistic regression analysis identified hip joint involvement,elevated CRP,ESR,BALP,and CX3CL1 levels as independent risk factors for unfavorable prognosis in AS[OR(95%CI)=6.641(1.993-22.131),1.092(1.009-1.182),1.203(1.089-1.329),1.039(1.020-1.059),4.644(2.145-10.056)].The AUC for predicting unfavorable prognosis using serum BALP and CX3CL1 levels and th

关 键 词：强直性脊柱炎 骨特异性碱性磷酸酶 C-X3-C基序趋化因子配体1 疾病严重程度 预后 

分 类 号：R593.23[医药卫生—内科学]