当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2015年
5期
8-10,11
,共4页
崔银风%张莉芸%张改连%许珂%马丹%郭东强%闫俊荣
崔銀風%張莉蕓%張改連%許珂%馬丹%郭東彊%閆俊榮
최은풍%장리예%장개련%허가%마단%곽동강%염준영
强直性脊柱炎%中轴型脊柱关节炎%Dickkopf-1%骶髂关节X线%骶髂关节磁共振成像
彊直性脊柱炎%中軸型脊柱關節炎%Dickkopf-1%骶髂關節X線%骶髂關節磁共振成像
강직성척주염%중축형척주관절염%Dickkopf-1%저가관절X선%저가관절자공진성상
Ankylosing spondylitis%Axial spondyloarthropathy%Dickkopf-1%Sacroiliitis joint X-ray%MRI
目的：通过检测中轴型脊柱关节炎（ax-SpA）患者血清Dickkopf-1（DKK-1）水平，并进行相关性分析。方法（1）采用酶联免疫吸附法（ELISA）检测71例初次就诊ax-SpA患者[其中51例强直性脊柱炎（AS）和20例非放射中轴型脊柱关节炎（nr-axSpA）]、疾病对照组34例（其中14例类风湿关节炎、10例骨关节炎和10例痛风患者）和15例健康人，分别检测血清DKK-1水平；（2）根据HLA-B27表达情况，将ax-SpA患者分为阳性组（48例）和阴性组（23例）；按照修订纽约放射学骶髂关节炎分级标准，AS患者分为Ⅱ级（16例）、Ⅲ级（12例）和Ⅳ级（23例），比较不同分组血清DKK-1的表达差异；（3）分析血清DKK-1水平与ax-SpA患者临床指标、炎性指标及影像学评分的相关性。结果（1）AS患者血清DKK-1水平[（2133.9±432.9） ng/L]高于疾病对照组（RA、OA和Gout患者）和健康人[（1718.7±260.4）ng/L]，差异有统计学意义（P<0.05）。而低于nr-axSpA患者[（2303.9±289.4）ng/L]，差异无统计学意义。（2）ax-SpA患者HLA-B27阳性血清DKK-1水平[（2150.47±440.9）ng/L]低于HLA-B27阴性患者[（2418.8±319.5）ng/L]，差异有统计学意义（P<0.05）。AS患者放射学骶髂关节炎Ⅳ级血清DKK-1水平[（1878.91±285）ng/L]低于Ⅱ级[（2248.18±365.53）ng/L]，差异有统计学意义（P<0.05），而Ⅲ级血清DKK-1水平分别与Ⅱ级[（2248.18±365.53）ng/L]、Ⅳ级[（1878.91±285）ng/L]比较，差异无统计学意义。（3）血清DKK-1水平与ax-SpA患者病程(r=-0.424,P=0.0001)、BASMI(r=-0.264,P=-0.026)和AS患者mSASSS评分(r=-0.581,P=0.023)呈负相关，而与ax-SpA患者临床指标、炎性指标及SPARCC评分无相关性。结论血清DKK-1水平随着渐进骨化程度的加重呈下降趋势，可能是AS发生关节强直和骨赘形成的一个重要因素；血清DKK-1水平可以作为评价AS骨化程度的潜在生物学标志物之一。
目的：通過檢測中軸型脊柱關節炎（ax-SpA）患者血清Dickkopf-1（DKK-1）水平，併進行相關性分析。方法（1）採用酶聯免疫吸附法（ELISA）檢測71例初次就診ax-SpA患者[其中51例彊直性脊柱炎（AS）和20例非放射中軸型脊柱關節炎（nr-axSpA）]、疾病對照組34例（其中14例類風濕關節炎、10例骨關節炎和10例痛風患者）和15例健康人，分彆檢測血清DKK-1水平；（2）根據HLA-B27錶達情況，將ax-SpA患者分為暘性組（48例）和陰性組（23例）；按照脩訂紐約放射學骶髂關節炎分級標準，AS患者分為Ⅱ級（16例）、Ⅲ級（12例）和Ⅳ級（23例），比較不同分組血清DKK-1的錶達差異；（3）分析血清DKK-1水平與ax-SpA患者臨床指標、炎性指標及影像學評分的相關性。結果（1）AS患者血清DKK-1水平[（2133.9±432.9） ng/L]高于疾病對照組（RA、OA和Gout患者）和健康人[（1718.7±260.4）ng/L]，差異有統計學意義（P<0.05）。而低于nr-axSpA患者[（2303.9±289.4）ng/L]，差異無統計學意義。（2）ax-SpA患者HLA-B27暘性血清DKK-1水平[（2150.47±440.9）ng/L]低于HLA-B27陰性患者[（2418.8±319.5）ng/L]，差異有統計學意義（P<0.05）。AS患者放射學骶髂關節炎Ⅳ級血清DKK-1水平[（1878.91±285）ng/L]低于Ⅱ級[（2248.18±365.53）ng/L]，差異有統計學意義（P<0.05），而Ⅲ級血清DKK-1水平分彆與Ⅱ級[（2248.18±365.53）ng/L]、Ⅳ級[（1878.91±285）ng/L]比較，差異無統計學意義。（3）血清DKK-1水平與ax-SpA患者病程(r=-0.424,P=0.0001)、BASMI(r=-0.264,P=-0.026)和AS患者mSASSS評分(r=-0.581,P=0.023)呈負相關，而與ax-SpA患者臨床指標、炎性指標及SPARCC評分無相關性。結論血清DKK-1水平隨著漸進骨化程度的加重呈下降趨勢，可能是AS髮生關節彊直和骨贅形成的一箇重要因素；血清DKK-1水平可以作為評價AS骨化程度的潛在生物學標誌物之一。
목적：통과검측중축형척주관절염（ax-SpA）환자혈청Dickkopf-1（DKK-1）수평，병진행상관성분석。방법（1）채용매련면역흡부법（ELISA）검측71례초차취진ax-SpA환자[기중51례강직성척주염（AS）화20례비방사중축형척주관절염（nr-axSpA）]、질병대조조34례（기중14례류풍습관절염、10례골관절염화10례통풍환자）화15례건강인，분별검측혈청DKK-1수평；（2）근거HLA-B27표체정황，장ax-SpA환자분위양성조（48례）화음성조（23례）；안조수정뉴약방사학저가관절염분급표준，AS환자분위Ⅱ급（16례）、Ⅲ급（12례）화Ⅳ급（23례），비교불동분조혈청DKK-1적표체차이；（3）분석혈청DKK-1수평여ax-SpA환자림상지표、염성지표급영상학평분적상관성。결과（1）AS환자혈청DKK-1수평[（2133.9±432.9） ng/L]고우질병대조조（RA、OA화Gout환자）화건강인[（1718.7±260.4）ng/L]，차이유통계학의의（P<0.05）。이저우nr-axSpA환자[（2303.9±289.4）ng/L]，차이무통계학의의。（2）ax-SpA환자HLA-B27양성혈청DKK-1수평[（2150.47±440.9）ng/L]저우HLA-B27음성환자[（2418.8±319.5）ng/L]，차이유통계학의의（P<0.05）。AS환자방사학저가관절염Ⅳ급혈청DKK-1수평[（1878.91±285）ng/L]저우Ⅱ급[（2248.18±365.53）ng/L]，차이유통계학의의（P<0.05），이Ⅲ급혈청DKK-1수평분별여Ⅱ급[（2248.18±365.53）ng/L]、Ⅳ급[（1878.91±285）ng/L]비교，차이무통계학의의。（3）혈청DKK-1수평여ax-SpA환자병정(r=-0.424,P=0.0001)、BASMI(r=-0.264,P=-0.026)화AS환자mSASSS평분(r=-0.581,P=0.023)정부상관，이여ax-SpA환자림상지표、염성지표급SPARCC평분무상관성。결론혈청DKK-1수평수착점진골화정도적가중정하강추세，가능시AS발생관절강직화골췌형성적일개중요인소；혈청DKK-1수평가이작위평개AS골화정도적잠재생물학표지물지일。
Objective To detect serum levels of DKK-1(Dickkopf-1) in axial spondyloarthropathy (ax-SpA) and correlation analysis.Methods (1) Enzyme-linked immunosorbent assay (ELISA) was used to detect 71 cases of patients with initial visiting ax-SpA [including 51 cases of ankylosing spondylitis (AS) and 20 cases of non- radiology axial spondyloarthropathy (nr-axSpA)] and serum levels of DKK-1 in disease control groups (14 cases of RA, 10 patients of OA and 10 cases of gout patients) and 15 cases of healthy control group; (2)According to the expression of HLA-B27,ax-SpA patients were divided into positive group (48 cases) and negative group (23 cases);accordance with the revised New York radiological sacroiliitis grading standards,ax-SpA patients were divided into gradeⅡ (16 cases), gradeⅢ (12 cases) and gradeⅣ (23 cases), comparing to expression differences of serum DKK-1 in different groups; (3)Correlation analysis serum levels of DKK-1 with ax-SpA patients clinical indicators,inflammatory markers and radiographic score.Results (1)Serum levels of DKK-1 in AS patients [(2133.9±432.9)ng/L] higher than disease control groups (including RA, OA and Gout patients) and healthy control group [(1718.7±260.4)ng/L],it has a statistical significance (P<0.05). But lower than nr-axSpA patients [(2303.9±289.4)ng/L], the difference was not statistically significant. (2)Serum DKK-1 levels in ax-SpA patients with HLA-B27 positive below HLA-B27 negative patients [(2150.47±440.9)ng/L], the difference had a statistically significant (P<0.05). Serum levels of DKK-1 in radiographic sacroiliitis gradeⅣ patients [(1878.91±285)ng/L] and gradeⅢ patients [(2059.33±324.26)ng/L], the difference had a statistically significant (P<0.05), whereas serum levels of DKK-1 with gradeⅡ [(2248.18±365.53)ng/L] andⅢ grade [(2248.18±365.53)ng/L], gradeⅢ and gradeⅣ, differences was no statistically significant. (3)Serum levels of DKK-1 with duration (r=-0.424P=0.0001), BASMI (r=-0.264,P=-0.026) of ax-SpA patients and mSASSS score of AS patients (r=-0.581,P=0.023) were negatively correlated, Serum levels of DKK-1 with ax-SpA patients in clinical indicators,inflammatory markers and SPARCC score was no correlation.Conclusion With the severity of progressive ossification, DKK-1 level downward trend that may be an important factor in the occurrence of ankylosis and osteophyte formation of AS; DKK-1 level as one of potential biological markers that can be evaluated ossification degree of AS.
