摘要
目的探讨14-3-3η检测对类风湿关节炎(RA)的诊断价值,并分析其与RA患者骨代谢水平的相关性。方法纳入2016年9月-2017年12月南昌大学第二附属医院收治的113例RA患者为RA组,40例骨性关节炎(OA)和37例强直性脊柱炎(AS)患者为non-RA组,以及该院同期健康体检者77例为健康对照组。ELISA法检测14-3-3η水平,绘制受试者工作曲线(ROC),通过曲线下面积(AUC)评价14-3-3η对RA的诊断价值并确定截断值。根据血清14-3-3η蛋白水平将RA患者分为3组,对比不同14-3-3η水平患者Ⅰ型胶原氨基端前肽(PINP)、β-胶原降解产物(β-CTx)及骨钙素(OC)等骨代谢指标水平。对RA患者14-3-3η、类风湿因子(RF)、抗环瓜氨酸多肽抗体(anti-CCP)及骨代谢相关指标进行相关性分析。结果 14-3-3η诊断RA的AUC为0.845,与RF及anti-CCP联合诊断RA的AUC为0.907;PINP和β-CTx水平在高14-3-3η组明显升高,二者与14-3-3η的相关系数(r)分别为0.817和0.808。结论 14-3-3η检测有助于RA诊断,联合RF和anti-CCP可提高RA诊断水平,并能反映RA患者的骨代谢水平。
Objective To explore the clinical value of 14-3-3η on diagnosis of rheumatoid arthritis （RA） and analyze its correlation with bone metabolism levels in patients with RA. Methods Serum levels of 14-3-3η were detected using ELISA, and ROC curve was performed to evaluate the diagnostic value of 14-3-3η via comparing the area under ROC curve （AUC）, and determine the cut-offvalue. All RA patients were classified into three groups according to serum 14-3-3η levels. The serum levels of bone metabolism indices [including 25-hydroxy vitamin D3 （25-（OH）D）, bone alkaline phosphatase （BALP）, osteocalcin （OC）, aminoterminal propeptide of type I collagen （PINP）, β-crosslaps （β-CTx） and parathyroid hormone （PTH）] in RA patients with different levels of 14-3-3η were compared among the three groups. The correlations between 14-3-3η, rheumatoid factor （RF）, anti-cyclic citrulline polypeptide antibody （anti-CCP） and bone metabolism indices were then analyzed. Results Serum levels of 14-3-3η were remarkably elevated in patients with inflammatory arthropathy, RA in particular. The AUC of 14-3-3η for RA diagnosis were 0.845, and the AUC was 0.907 when combined 14-3-3η with RF and anti-CCP. Levels of PINP and β-CTx were significantly higher in the higher 14-3-3η groups compared to those in lower serum levels of 14-3-3η protein, and their correlation coefficient （r） with 14-3-3η was 0.817 and 0.808, respectively. Conclusions 14-3-3η was helpful to the diagnosis of RA. Combination of 14-3-3η with RF and anti-CCP can improve the diagnostic rate of RA, and may well reflect the bone metabolism level of RA patients.
作者
曾婷婷
谭立明
田永建
余建林
吴洋
蒋永清
ZENG Ting-ting;TAN Li-ming＇;TIAN Yong-jian;YU Jian-lin;WU Yang;JIANG Yong-qing(Department of Clinical Laboratory,Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2018年第8期680-684,共5页
Medical Journal of Chinese People's Liberation Army
基金
江西省卫生计生委科技计划(20181073)
南昌大学研究生创新专项资金~~
