血清铁蛋白与类风湿性关节炎疾病活动性的关系

Relationship between the Concentration of Serum Ferritin and Disease Activity Score（DAS28） in Patients with Rheumatoid Arthritis

目的观察类风湿性关节炎（RA）患者血清铁蛋白水平的变化，分析血清铁蛋白与RA疾病活动性、C反应蛋白（CRP）及抗环瓜氨酸肽（CCP）抗体、类风湿因子（RF）的关系。方法入选RA患者68例，健康对照60例，分别检测血清铁蛋白、抗CCP抗体、CRP，RF和红细胞沉降率（ESR）。记录RA患者的临床资料，疾病活动性以DAS28评分表示。分析RA患者血清铁蛋白水平与DAS28评分、CRP、抗CCP抗体和RF的关系。结果11．8％的RA患者血清铁蛋白升高；RA患者血清铁蛋白平均水平比对照组显著升高（t=11．79，P〈0．01）；重度活动组（DAS28〉5．1）血清铁蛋白水平明显高于轻中度组和缓解组（DAS28≤5．1），差异有统计学意义（P〈0．01）；血清铁蛋白水平与DAS28评分和CRP成正相关（r=0．485，P〈0．05和r=0．633，P〈O．01），与抗CCP抗体和RF无相关性（r=0．211，P〉0．05和r=0．157，P〉0．05）。结论血清铁蛋白水平反映了RA患者的疾病活动状态，是除CRP外的又一个评价RA疾病活动性的重要指标。

Objective To investigate the relationship between the concentration of serum ferritin and disease activity score （DAS28） in patients with rheumatoid arthritis（RA）. Methods The study included 68 patients with RA and 60 healthy controls. Laboratory tests included ferritin,C-reactive protein（CRP）,anti-cyclic citrullinated peptide （anti-CCP） antibody, rheumatoid factor（RF） and erythrocyte sedimentation rate （ESR）. The Disease Activity Score 28 （DAS28） was used to e- valuae disease activity of RA patients. Results Hyperferritinemia was high in 11.8% of the RA patients and serum ferritin concentration in the RA group was higher than control groups （t= 11.79,P〈0. 01）. Patients with DAS28〉5.1 had signif- icantly higher ferritin concentration than other patients （222. 9±56. 8 vs 175.1±35.5 ,P〈0. 01）. The concentration of ferritin in RA was positively correlated with DAS28 and CRP （r= 0. 485 ,P〈0. 05 and r=0. 633,P〈0. 01,respectively）, wheares it was not correlated with anti-CCP antibody and rheumatoid factor （RF）. Conclusion Serum ferritin could reflect the disease activity in RA patients and it may be another potential marker for evaluating the disease activity of RA apart from CRP.