目的 探讨高迁移族蛋白B1(HMGB1)、系统免疫炎症指数(SII)、钙结合蛋白A8/A9复合物(S100A8/A9)和单核细胞趋化因子-1(MCP-1)在类风湿关节炎(RA)中的诊断及预后预测的价值.方法 选取2022年1-12月在鹰潭市人民医院和南昌大学第二附属医院确诊的154例RA患者作为RA组,选取同期303例非RA患者(包括78例干燥综合征、62例系统性红斑狼疮、79例强直性脊柱炎、84例骨关节炎)作为非RA组,43例健康体检者作为对照组.采用ELISA检测HMGB1、S100A8/A9、MCP-1水平,鞘流电阻抗法检测P L T和淋巴细胞水平,流式细胞技术结合荧光染色检测中性粒细胞水平,进而计算SII,并检测其他实验室指标.再根据28个关节疾病活动度评分(DAS28)将RA组分为缓解组(n=35)、低疾病活动组(n=27)、中疾病活动组(n=50)和高疾病活动组(n=42),进一步评价疗效,并对RA患者治疗前(T0)及治疗后1、2、3个月(T1、T2、T3)随访观察,分析各时间指标之间的相关性.结果 RA组HMGB1、SII、S100A8/A9、MCP-1水平高于对照组(P＜0.05),诊断RA的曲线下面积分别为0.86、0.79、0.84和0.80.HMGB1、SII、S100A8/A9和MCP-1在类风湿因子(RF)阴性或抗环瓜氨酸肽抗体(CCP)阴性患者中的阳性率分别为37.50％、37.50％、50.00％和62.50％.高、中疾病活动组HMGB1、S100A8/A9、MCP-1水平分别高于低疾病活动组、缓解组和对照组(P＜0.05).HMGB1、SII、S100A8/A9、MCP-1 水平与 DSA28 评分呈正相关(r=0.476、0.286、0.522、0.441,P＜0.05);RA患者治疗前后HMGB1、SII、S100A8/A9、MCP-1变化值与DAS28变化值也呈正相关(r=0.628、0.524、0.603、0.579,P＜0.05).结论 HMGB1、SII、S100A8/A9、MCP-1 可用于 RA 患者疾病活动性监测和病情评估.
Application of HMGB1,SII,S100A8/A9 and MCP-1 in rheumatoid arthritis
Objective To explore the predictive value of high mobility group box1 protein B1(HMGB1),systemic immune inflammatory index(SII),calcium binding protein A8/A9 complex(S100A8/A9)and monocyte chemoattractant protein-1(MCP-1)in diagnosis and prognosis of rheumatoid arthritis(RA).Methods A total of 154 patients with definitely diagnosed RA in Yingtan Municipal People's Hospital and Second Affiliated Hospital of Nanchang University from January to December 2022 were selected as the RA group,303 patients with non-RA(including 78 cases of Sjogren's syndrome,62 cases of systemic lupus er-ythematosus,79 cases of ankylosing spondylitis and 84 cases of osteoarthritis)during the same period were se-lected as the non-RA group,and 43 healthy people undergoing the physical examination served as the control group.The levels of HMGB1,S100A8/A9 and MCP-1 were detected by ELISA,the levels of platelets(PLT)and lymphocytes were detected by the sheath flow electrical impedance method,the neutrophils level was de-tected by flow cytometry combined with fluorescence staining,then SII was calculated and the other laboratory indicators were detected.The RA group was divided into the remission group(n=35),low disease activity group(n=27),middle disease activity group(n=50)and high disease activity group(n=42)according to the disease activity index 28 score(DAS28).The treatment effect was further evaluated.The patients were followed up and observed before treatment(T0),and in 1,2,3 months after treatment(T1,T2,T3).Then the correlation among the indicators in various time was analyzed.Results The levels of HMGB1,SII,S100A8/A9 and MCP-1 in the RA group were higher than those in the control group(P＜0.05),their area under curve(AUC)for diagnosing RA were 0.86,0.79,0.84 and 0.80,respectively.The positive rates of HMGB1,SII,S100A8/A9 and MCP-1 in the patients with rheumatoid factor(RF)negative or anti-cyclic citrullinated pep-tide(CCP)negative were 37.50％,37.50％,50.00％and 62.50％,respectively.The levels of HMGB1,S100A8/A9 and MCP-1 in the high disease activity group and middle disease activity group were higher than those in the low disease activity group,remission group and control group(P＜0.05).The levels of HMGB1,SII,S100A8/A9 and MCP-1 were positively correlated with the DSA28 score(r=0.476,0.286,0.522,0.441,P＜0.05);the changed values of HMGB1,SII,S100A8/A9 and MCP-1 before and after treatment in RA pa-tients also was positively correlated with DAS28 changed value(r=0.628,0.524,0.603 and 0.579,P＜0.05).Conclusion HMGB1,SII,S100A8/A9 and MCP-1 could be used for the monitoring of disease activity and disease condition evaluation in the patients with RA.
rheumatoid arthritishigh mobility group box1 protein B1systemic immune inflammation indexcalcium binding protein A8/A9 complexmonocyte chemoattractant protein-1
国家科技期刊平台
NSTL
万方数据
