摘要
目的探索正五聚体蛋白-3(pentraxin-3,PTX-3)在评估多发性大动脉炎(Takayasu′s arteritis,TA)病情活动性方面的价值。方法选取2010年10月至2012年3月就诊于复旦大学附属中山医院风湿科的TA患者45名、健康体检者25名及类风湿关节炎(rheumatoid arthritis,RA)患者10名,采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISAs)检测血浆PTX-3水平,采用Kerr指标作为疾病活动性评定的金标准。结果 TA患者血浆PTX-3水平显著高于健康人[(18.5±13.9)ng/mL vs.(0.52±0.26)ng/mL,P<0.01]和RA患者[(18.5±13.9)ng/mL vs.(0.73±0.47)ng/mL,P<0.01];且活动期患者PTX-3水平显著高于稳定期患者[(26.7±16.8)ng/mL vs.(6.2±4.7)ng/mL,P<0.01],并与疾病活动性评分呈正相关(Rho=0.78,P<0.01);而健康人与RA患者血浆PTX-3水平差异无统计学意义。结合其他实验室检查及影像学结果分析后发现,TA患者血浆PTX-3水平与血清基质金属蛋白酶(matrix metalloproteinase,MMP)-9水平(Rho=0.65,P<0.01)、全身血管磁共振(magnetic resonance imaging,MRI)上受累血管管腔狭窄程度(Rho=0.67,P=0.04)及管壁增厚程度(Rho=0.54,P=0.05)呈正相关。ROC曲线分析表明,PTX-3(≥10.71ng/mL)在评估TA活动性方面的敏感性为88.89%,特异性为77.78%,准确性为84.44%(ROC曲线下面积=0.95,95%CI:0.89～1.00)。结论 PTX-3有望成为一种评估TA病情活动性的有效的血清学指标,且其血浆水平可能反映了患者血管损伤情况,用于监测疾病活动性。
Objective To investigate the value of status in Takayasu＇s arteritis （TA）. Methods pentraxin-3 （PTX-3） for evaluating the disease Circulating PTX-3 level was determined in 45 Chinese TA patients,25 healthy donors and 10 rheumatoid arthritis （RA） patients from October,2010 to March, 2012. Enzyme linked immunosorbent assay （ELISA） was employed to detect the plasma PTX-3 level. Kerr＇s index was used as the golden standard of disease activity. Results PTX-3 plasma level in TA patients was significantly higher than those in healthy controls [（18.5 ± 13.9） ng/mL vs. （0. 52 ±11. 26） ng/mL,P〈0.01）] and RApatients[（18.5±13.9） ng/mL us. （ 0. 73 ±1）. 47 ng/ml.）,P〈0. 0l）;however, PTX3 levels were similar in healthy donors and RA controls （P = 0.49）. Plasma level of PTX-3 was significantly higher in active TA than inactive TA patients [（26.7 ± 16.8） ng/mI, vs. （6.2± 4.7） ng/ml.,P〈0. 01],and was positively related to TA disease activity score （Rho = 0.78, P〈0.01 ） and serum MMP-9 levels （Rho = 0.65, P〈0.01 ）. Furthermore, plasma PTX-3 level was positively related to the serum matrix metalloproteinase-9 （MMP-9） level （Rho- 0.65,P〈0.01） ,severity of lumen stenosis （Rho = 0.67,P = 0.04） and wall thickness （Rho = 0. 54, P = I）. 05） on the delayed contrast enhanced magnetic resonance imaging （MRI） of TA patients. PTX-3 （≥11）. 71 ng/mL） had a sensitivity, specificity and accuracy of 88. 89%,77.78% and 84. 44% to identify TA disease activity （area under the ROC curve = 0.95,95% CI：0.89-1.00）. Conclusions PTX-3 may be sensitive and specific for the evaluation of disease status in TA, and might also reflect prior vessel damage, and monitor disease progression.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2013年第4期390-394,406,共6页
Fudan University Journal of Medical Sciences
基金
上海市科学技术委员会基金(10411962300)~~
