摘要
目的分析类风湿关节炎(RA)患者血清富亮氨酸α-2糖蛋白-1(LRG1)、可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)表达水平及临床意义。方法纳入100例RA患者作为RA组,另选取100例同期的健康者作为对照组。根据28个关节疾病活动度(DAS28)评分将所有RA患者分为轻度RA组(32例)、中度RA组(28例)与重度RA组(40例)。收集所有患者的一般临床资料及实验室检查结果并分组比较。采用pearson相关分析评估血清LRG1、sTWEAK的相关性及二者与RA临床指标的相关性;采用多因素logistic回归分析评估发生中/重度RA的危险因素;采用受试者工作特征(ROC)曲线评估LRG1、sTWEAK对中/重度RA的诊断价值。结果RA组血清LRG1、sTWEAK表达水平明显高于对照组(P<0.001)。轻度RA组、中度RA组与重度RA组患者类风湿因子(RF)、C反应蛋白(CRP)、红细胞沉降率(ESR)、纤维蛋白原(FIB)、纤维蛋白降解产物(FDP)、LRG1、sTWEAK表达水平及DAS28评分均依次升高(P<0.05)。Pearson相关分析结果显示,RA患者血清LRG1水平与sTWEAK表达水平均与RF、CRP、ESR、FIB、FDP、DAS28评分呈正相关;RA患者血清LRG1水平与sTWEAK表达水平呈显著正相关(P<0.05);多因素logistic回归分析结果显示,RF、CRP、ESR、LRG1、sTWEAK均是中/重度RA发生的危险因素(P<0.05)。ROC曲线分析结果显示,血清LRG1、sTWEAK诊断中/重度RA的曲线下面积(AUC)分别为0.858、0.852,均低于两者联合检测的AUC(0.939,P<0.05)。结论LRG1、sTWEAK在RA患者血清中高表达,随着病情加重,LRG1、sTWEAK逐渐升高,两者与RA患者的临床指标关系密切,对中/重度RA有一定的诊断价值。
Objective To analyze the serum levels and clinical significance of leucine rich alpha⁃2⁃glycoprotein⁃1(LRG1)and soluble tumor necrosis factor⁃like weak inducer of apoptosis(sTWEAK)in patients with rheumatoid arthritis(RA).Methods A total of 100 RA patients were included as RA group,and another 100 healthy individuals from the same period were included as control group.According to the disease activity score 28(DAS28),all RA patients were divided into mild RA group(32 cases),moderate RA group(28 cases)and severe RA group(40 cases).The general clinical data and laboratory test results of all patients were collected and compared in groups.Pearson correlation analysis was used to evaluate the correlation between serum LRG1 and sTWEAK was used,as well as their correlation with clinical indicators of RA.Multiple logistic regression analysis was used to evaluate the risk factors for moderate/severe RA.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of LRG1 and sTWEAK for moderate/severe RA.Results The expression levels of serum LRG1 and sTWEAK in RA group were significantly higher than those in control group(P<0.001).The expression levels of rheumatoid factor(RF),C⁃reactive protein(CRP),erythrocyte sedimentation rate(ESR),fibrinogen(FIB),fibrin degradation products(FDP),LRG1,sTWEAK and DAS28 score in the mild RA group,moderate RA group and severe RA group gradually increased successively(P<0.05).Pearson correlation analysis showed that the expression levels of LRG1 and sTWEAK in the serum of RA patients were positively correlated with RF,CRP,ESR,FIB,FDP and DAS28 score;The expression levels of serum LRG1 and sTWEAK in RA patients were significantly positively correlated(P<0.05);The results of multivariate logistic regression analysis showed that RF,CRP,ESR,LRG1 and sTWEAK were all risk factors for moderate/severe RA(P<0.05).ROC curves analysis result shows that the areas under the curve(AUC)of serum LRG1 and sTWEAK for diagnosing moderate/severe RA were 0.858 and 0.852,respectively,which were both lower than the AUC of the combined detection of the two(0.939,P<0.05).Conclusion LRG1 and sTWEAK are highly expressed in the serum of RA patients.As the condition worsens,LRG1 and sTWEAK gradually increaseThe two are closely related to the clinical indicators of RA patients and have certain diagnostic value for moderate/severe RA.
作者
付颖
冯军
谭淳予
Fu Ying;Feng Jun;Tan Chunyu(Department of Rheumatology and Immunology,903 Hospital,Jiangyou Sichuan,621700,China;不详)
出处
《临床内科杂志》
2025年第5期383-386,共4页
Journal of Clinical Internal Medicine
