CAJ | 학술논문

目的：探讨可溶性髓样细胞触发受体－1（sTREM－1）、肿瘤坏死因子－α（TNF－α）、白细胞介素－6（IL－6）在老年类风湿性关节炎（ EORA）患者临床诊断中的意义。方法选择42例活动期EORA、38例稳定期EORA患者、37例其他风湿免疫系统疾病患者（疾病对照组）及34例健康对照者，通过ELISA法检测血清TNF－α、sTREM－1、IL－6表达水平，绘制ROC曲线分析评价三种细胞炎性因子诊断EORA的特异性、敏感性及诊断效能。结果 EORA患者中，活动期和稳定期的TNF－α、sTREM－1、IL－6表达水平均高于健康对照组，（P＜0．05），且活动期TNF－α、sTREM－1、IL－6水平均高于稳定期，（P＜0．05）。与疾病对照组比较，活动期RA组三项检测指标均不具有统计学意义（P＞0．05）。活动期RA患者sTREM－1水平与TNF－α、IL－6及反应疾病活动的指标C反应蛋白（CRP）、血沉（ESR）水平之间均具有正相关性（P＜0．05）。通过比较ROC曲线下面积大小，sTREM－1的诊断效能和TNF－α接近，敏感性依次为91．4％、89．5％，特异性依次为89．3％、92．6％。 sTREM－1、TNF－α和IL－6三项指标联合检测的诊断特异性最高为98．3％。结论血清中sTREM－1、TNF－α和IL－6水平测定有助于EORA患者的临床诊断，sTREM－1可能成为EORA活动性新指标，三项指标联合检测可提高其特异性。
목적：탐토가용성수양세포촉발수체－1（sTREM－1）、종류배사인자－α（TNF－α）、백세포개소－6（IL－6）재노년류풍습성관절염（ EORA）환자림상진단중적의의。방법선택42례활동기EORA、38례은정기EORA환자、37례기타풍습면역계통질병환자（질병대조조）급34례건강대조자，통과ELISA법검측혈청TNF－α、sTREM－1、IL－6표체수평，회제ROC곡선분석평개삼충세포염성인자진단EORA적특이성、민감성급진단효능。결과 EORA환자중，활동기화은정기적TNF－α、sTREM－1、IL－6표체수평균고우건강대조조，（P＜0．05），차활동기TNF－α、sTREM－1、IL－6수평균고우은정기，（P＜0．05）。여질병대조조비교，활동기RA조삼항검측지표균불구유통계학의의（P＞0．05）。활동기RA환자sTREM－1수평여TNF－α、IL－6급반응질병활동적지표C반응단백（CRP）、혈침（ESR）수평지간균구유정상관성（P＜0．05）。통과비교ROC곡선하면적대소，sTREM－1적진단효능화TNF－α접근，민감성의차위91．4％、89．5％，특이성의차위89．3％、92．6％。 sTREM－1、TNF－α화IL－6삼항지표연합검측적진단특이성최고위98．3％。결론혈청중sTREM－1、TNF－α화IL－6수평측정유조우EORA환자적림상진단，sTREM－1가능성위EORA활동성신지표，삼항지표연합검측가제고기특이성。
Objective To evaluate the significance of serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), tumor necrosis factor-α( TNF-α), and interleukin-6 ( IL-6) in the diagnosis of elderly onset rheumatoid arthritis (EORA).Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of sTREM-1, TNF-α, and IL-6 in 42 patients with the active stage of EORA, 38 patients with the inactive stage of EORA, 37 patients with other antoimmune disease, and 34 healthy subjects.The receiver operating characteristic ( ROC ) curves were used to analyze the specificity, sensitivity and diagnostic efficiency.Results The serum levels of sTREM-1, TNF-α, and IL-6 were significantly higher in the active phase and the inactive phase of EORA than in healthy controls (P<0.05), and they were significantly higher in the active phase of EORA than in the inactive phase of EORA (P<0.05).Compared with the other antoimmune diseases group, the serum levels of sTREM-1, TNF-α, and IL-6 were no significant difference in the active phase of EORA (P>0.05).The serum level of sTREM-1 in the active phase of EORA was positively correlated with TNF-α, IL-6, CRP, and ESR levels ( P<0.05) .The diagnostic efficiency of sTREM-1 was similar to that of TNF-αby comparison of the area under the curve of ROC.The sensitivity and specificity of sTREM-1 and TNF-αin diagnosis of EORA were 91.4% and 89.5%, 89.3% and 92.6%, respectively.The highest specificity of combined detection with TREM-1, TNF-α, and IL-6 was 98.3%.Conclusion Detection of serum sTREM-1, TNF-α, and IL-6 levels is helpful in the diagnosis of EORA.sTREM-1 is a potent serum marker for clinical activity of EORA. Furthermore, combined detection with sTREM-1, TNF-α, and IL-6 increases the specificity of the diagnosis of EORA.