血清sST2在类风湿性关节炎病情及疗效监测中的价值

doi:10.3969/j.issn.1673-8640.2021.012.009

摘要/Abstract

摘要：

目的探讨血清可溶性基质裂解素2（sST2）水平在类风湿性关节炎（RA）病情观察及疗效监测中的价值。方法采用酶联免疫吸附试验（ELISA）检测75例RA患者（RA组）及50名体检健康者（正常对照组）的血清sST2水平,同时检测RA患者C反应蛋白（CRP）、红细胞沉降率（ESR）、类风湿因子（RF）等指标,采用疾病活动指数28（DAS28）评分评价RA的疾病活动度和药物疗效。对33例接受药物治疗的RA患者中的28例追踪2个治疗周期、5例追踪4个治疗周期。采用Pearson相关分析评价sST2与各指标的相关性。采用多元回归分析评估血清sST2水平的影响因素。结果 RA组血清sST2水平显著高于正常对照组（P<0.01）。Pearson相关分析结果显示,RA患者血清sST2水平与CRP、ESR水平及DSA28评分均呈正相关（r值分别为0.534、0.487、0.794,P<0.05）,与RF水平无相关性（r=0.095,P>0.05）。多元回归分析结果显示,CRP和ESR是患者血清sST2水平的影响因素[回归方程为sST2=28.162+0.249×CRP+0.091×ESR（r²=0.675,P<0.05）]。RA患者治疗后sST2、CRP、ESR水平及DAS28评分均低于治疗前（P<0.01）,RF治疗前后差异无统计学意义（P>0.05）。RA患者治疗前、后的血清sST2水平变化值（△sST2）与DAS28评分变化值（△DAS28评分）呈正相关（r=0.447,P=0.002）。结论 sST2或可作为RA病情监测和疗效评估的指标。

关键词: 可溶性基质裂解素2, 疾病活动度, 类风湿性关节炎

Abstract:

Objective To investigate the value of serum soluble stromelysin 2（sST2）level in the observation of rheumatoid arthritis（RA） and the monitoring of therapeutic effect. Methods Serum sST2 levels in 75 RA patients（RA group）and 50 healthy subjects（control group） were determined by enzyme-linked immunosorbent assay（ELISA）,and C-reactive protein（CRP）,erythrocyte sedimentation rate（ESR）and rheumatoid factor（RF） in RA patients were determined as well. Disease activity score 28（DAS28） was used to evaluate the disease activity of RA and drug efficiency. Of the 33 RA patients who received drug therapy,28 patients were followed up for 2 treatment cycles,and 5 patients were followed up for 4 treatment cycles. Pearson correlation analysis was used to evaluate the correlation between sST2 and various indicators. Multiple regression analysis was used to evaluate the influencing factors of serum sST2 level. Results The level of serum sST2 in RA group was higher than that in control group（P<0.01）. Pearson correlation analysis showed that serum sST2 level was positively correlated with CRP,ESR and DAS28（r values were 0.534,0.487 and 0.794,respectively,P<0.05）,while no correlation was observed between sST2 and RF（r=0.095,P>0.05）. Multiple regression analysis results showed that CRP and ESR were independent factors influencing serum sST2 level [the regression equation was sST2=28.162+0.249×CRP+0.091×ESR（r²=0.675,P<0.05）]. Serum sST2,CRP,ESR and DAS28 in RA patients were decreased after treatment（P<0.01）,and there was no statistical significance in RF before and after treatment（P>0.05）. There was a positive correlation between the change of serum sST2 level（△sST2）and the change of DAS28（△DAS28） in RA patients before and after treatment（r=0.447,P=0.002）. Conclusions The indicator,sST2,may be used to observe the change of RA and the monitoring of therapeutic effect.

Key words: Soluble stromelysin 2, Disease activity, Rheumatoid arthritis

中图分类号:

R446.1

张伟, 郭慧娟, 吴系美, 凌秀婷, 姜孝新, 刘运洪. 血清sST2在类风湿性关节炎病情及疗效监测中的价值[J]. 检验医学, 2021, 36(12): 1238-1242.

ZHANG Wei, GUO Huijuan, WU Ximei, LING Xiuting, JIANG Xiaoxin, LIU Yunhong. Application value of serum sST2 level in monitoring rheumatoid arthritis and therapeutic effect[J]. Laboratory Medicine, 2021, 36(12): 1238-1242.

图/表 6

参考文献 18

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项目	回归系数	标准误	t值	P值
CRP	0.249	0.084	2.954	0.004
ESR	0.091	0.044	2.033	0.045
RF	0.023	0.016	1.394	0.168
常数项	28.162	2.235	12.600	<0.001

项目	回归系数	标准误	t值	P值
CRP	0.249	0.084	2.954	0.004
ESR	0.091	0.044	2.033	0.045
RF	0.023	0.016	1.394	0.168
常数项	28.162	2.235	12.600	<0.001

治疗阶段	例数	sST2/（ng/mL）	CRP/（mg/L）	ESR/（mm/h）	RF/（IU/mL）	DAS28评分/分
T0	33	42.1±9.8	18.0（13.45~24.0）	32.0（25.0~57.5）	112.3（44.2~168.7）	5.9±1.1
T1	33	35.2±8.6^*	12.0（8.85~14.8）^*	27.0（13.0~51.0）^*	109.0（56.3~154.0）	4.6±0.9^*
T2	33	29.5±6.8^#*	7.7（5.55~11.0）^#*	25.0（15.0~37.5）^*	101.7（36.5~162.0）	3.1±0.8^#*

治疗阶段	例数	sST2/（ng/mL）	CRP/（mg/L）	ESR/（mm/h）	RF/（IU/mL）	DAS28评分/分
T0	33	42.1±9.8	18.0（13.45~24.0）	32.0（25.0~57.5）	112.3（44.2~168.7）	5.9±1.1
T1	33	35.2±8.6^*	12.0（8.85~14.8）^*	27.0（13.0~51.0）^*	109.0（56.3~154.0）	4.6±0.9^*
T2	33	29.5±6.8^#*	7.7（5.55~11.0）^#*	25.0（15.0~37.5）^*	101.7（36.5~162.0）	3.1±0.8^#*

治疗阶段	例数	△sST2/（ng/mL）	△DAS28评分/分
T0~T1	33	6.9±4.1	1.3±0.3
T1~T2	33	5.7±4.2	1.5±0.6
T0~T2	33	12.2±6.6	2.8±0.7