磁共振成像联合Gal-1和Gal-3水平对早期类风湿关节炎的诊断价值  

Diagnostic value of magnetic resonance imaging combined with serum levels of Gal-1 and Gal-3 for early rheumatoid arthritis

作　　者：吴磊 王宇翔[1] 贺兰 汪琴 季利君 熊敏超[1] WU Lei;WANG Yuxiang;HE Lan;WANG Qin;JI Lijun;XIONG Minchao(Department of Medical Imaging,Ezhou Central Hospital,Ezhou 436000,Hubei,China)

机构地区：[1]鄂州市中心医院医学影像科,湖北鄂州436000

出　　处：《西部医学》2025年第4期615-619,共5页Medical Journal of West China

摘　　要：目的探索磁共振成像(MRI)联合血清半乳糖凝集素-1(Gal-1)和半乳糖凝集素-3(Gal-3)水平对早期类风湿关节炎(RA)的诊断价值。方法选取2022年2月—2024年2月我院收治的118例早期RA患者作为早期RA组,同期选择120例良性关节炎患者作为良性关节炎组,100例健康体检者作为对照组。收集受检者一般资料,采用酶联免疫吸附(ELISA)法检测血清Gal-1、Gal-3水平,采用受试者工作特征(ROC)曲线分析血清Gal-1、Gal-3水平对早期RA的诊断价值,早期RA组与良性关节炎组均进行MRI检测,以美国风湿病学会(ACR)作为金标准,采用Kappa检验检测MRI联合血清Gal-1、Gal-3水平与ACR诊断早期RA的一致性。结果早期RA患者血清Gal-1、Gal-3水平高于良性关节炎组及对照组(P<0.05)。ROC曲线结果显示Gal-1单独诊断早期RA的曲线下面积(AUC)为0.820(95%CI:0.765~0.866),截断值为57.506 ng/mL;Gal-3单独诊断早期RA的AUC为0.812(95%CI:0.756~0.859),截断值为1.725 ng/mL,MRI联合血清Gal-1、Gal-3水平与ACR的一致性检验(Kappa值=0.832)高于MRI单独诊断(Kappa值=0.733)。MRI联合血清Gal-1、Gal-3水平诊断早期RA患者的敏感度及阴性预测值高于单一指标,漏诊率低于单一指标(P<0.05)。结论早期RA患者血清Gal-1、Gal-3水平升高,MRI联合血清Gal-1、Gal-3水平诊断早期RA的诊断效能较好。Objective To explore the diagnostic value of magnetic resonance imaging(MRI)combined with serum levels of galactin-1(Gal-1)and galactin-3(Gal-3)for early rheumatoid arthritis(RA).Methods A total of 118 early RA patients admitted from February 2022 to February 2024 were selected as the early RA group,120 patients with benign arthritis were selected as the benign arthritis group during the same period,and 100 healthy individuals were selected as the control group.The general information of the examinee was collected.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum Gal-1 and Gal-3 levels.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum Gal-1 and Gal-3 levels for early RA.Both the early RA group and the benign arthritis group underwent MRI testing,using the American College of Rheumatology(ACR)as the gold standard,the consistency between MRI combined with serum Gal-1 and Gal-3 levels and ACR diagnosis of early RA was detected by Kappa test.Results The serum levels of Gal-1 and Gal-3 in early RA patients were higher than those in the benign arthritis group and control group(P<0.05).ROC curve results showed that the area under the curve(AUC)of Gal-1 for diagnosing early RA alone was 0.820(95%CI:0.765-0.866),with a cutoff value of 57.506 ng/mL.The AUC of Gal-3 for diagnosing early RA alone was 0.812(95%CI:0.756-0.859),with a cutoff value of 1.725 ng/mL.The consistency test between the combination of MRI,serum Gal-1 and Gal-3 levels with ACR(Kappa value=0.832)was higher than that of MRI alone(Kappa value=0.733).The sensitivity and negative predictive values of serum Gal-1 and Gal-3 levels in diagnosing early RA patients were higher than those of a single indicator,and the missed diagnosis rate was lower than that of a single indicator(P<0.05).Conclusion Early RA patients have elevated serum Gal-1 and Gal-3 levels,and MRI combined with serum Gal-1 and Gal-3 levels has better diagnostic efficacy in early RA.

关 键 词：磁共振成像 半乳糖凝集素-1 半乳糖凝集素-3 类风湿关节炎 诊断价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R593.22[医药卫生—诊断学]