类风湿关节炎患者血清MBL、MASP-2、HsCRP与C_3水平的相关性

Correlation among serum MBL,MASP-2,HsCRP and C_3 levels in rheumatoid arthritis

目的研究类风湿关节炎(RA)患者血清中甘露糖结合凝集素(MBL)/MBL相关的丝氨酸蛋白酶-2(MASP-2)、Hs CRP和C3水平的相关性。方法收集50例RA患者(活动期和非活动期各25例)和40例健康对照者空腹静脉血,用酶联免疫吸附试验和免疫比浊试验分别检测血清MBL、MASP-2、Hs CRP和C3的水平。结果 RA组活动期和非活动期患者血清中MBL水平均显著低于健康对照组(10.05±2.14 ng/m L vs 26.97±11.78 ng/m L;14.79±3.93 ng/m L vs 26.97±11.78 ng/m L,P<0.05);RA组活动期和非活动期患者血清中MASP-2水平均显著低于健康对照组(75.90±9.21 ng/m L vs 251.78±34.50 ng/m L;107.8±14.90 ng/m L vs251.78±34.50 ng/m L)(P<0.05);RA组活动期和非活动期患者血清中Hs CRP水平显著高于健康对照组(40.53±34.81 mg/L vs1.42±1.70 mg/L;2.97±2.51 mg/L vs 1.42±1.70 mg/L,P<0.05),C3水平3组无差异;双变量Pearson相关性分析,RA患者组MBL与MASP-2含量均呈显著正相关(r=0.550,P=0.001)、与Hs CRP含量呈低度负性相关(r=-0.323,P=0.022);与C3含量无相关(r=0.022,P=0.882)。RA组MASP-2与Hs CRP含量呈低度负性相关(r=-0.453,P=0.001);与C3含量无相关(r=0.049,P=0.738)。经ROC曲线分析,Hs CRP曲线下面积最大(0.844,P=0.001),MASP-2和MBL曲线下面积较小(0.025,P=0.001;0.266,P=0.001),Hs CRP(84%)对RA诊断的敏感性高于MBL(10%)、MASP-2(40%)。结论 MBL与MASP-2水平与Hs CRP呈负相关关系,RA患者关节的炎症损伤程度越重,则血清MBL与MASP-2水平越低,提示MBL与MASP-2参与RA病理损伤过程,但二者的敏感性均较低,不能做为RA诊断及疾病活动程度评价的独立指标。

Objective To investigate the correlation among serum levels of manning- binding lectin(MBL), MBL- associated serine proteases- 2(MASP- 2), complement C3 and high- sensitive C reactive protein(Hs CRP) in patients with rheumatoid arthritis(RA). Methods Fasting venous blood were collected from 50 RA patients(25 in active stage and 25 in remission) and40 healthy subjects for detecting serum levels of MBL, MASP- 2, complement C3 and Hs CRP using enzyme- linked immunosorbent assay(ELISA) and immune turbidity assay. Results The serum levels of MBL and MASP-2 were significantly lower and Hs CRP level was significantly higher in patients with RA(in both acute stage and remission) than in the healthy control group(P<0.05), but complement C3 level was similar between the RA patients and control group. Bivariate Pearson correlation analysis showed that in RA patients, MBL was positively correlated with MASP- 2 level(r=0.550, P=0.001) and negatively with Hs CRP(r=- 0.323, P=0.022) but not correlated with C3(r=- 0.022, P=0.882); MASP- 2 was negatively correlated with Hs CRP(r=0.453, P=0.453) and was not correlated with C3(r=0.049, P=0.738). ROC curve analysis revealed the largest area under curve(AUC) of Hs CRP(0.844, P=0.001) and smaller AUCs of MBL(0.025, P=0.001) and MASP-2(0.266, P=0.001). Hs CRP had a much higher sensitivity(84%) than MBL(10%) and MASP-2(40%) in the diagnosis of RA. Conclusion In RA patients,MBL and MASP-2 are negatively correlated with Hs CRP level. Serum MBL and MASP-2 levels decrease with the progression of joint injury in RA patients, suggesting their involvement in the pathological process of RA; but due to their low sensitivity,they are not appropriate indicators for evaluating the disease activity of RA.