I型胶原吡啶交联终肽在评价强直性脊柱炎临床疗效中的作用

Role of ICTP in Evaluating Clinical Effect of Akylosing Spondylitis

目的探讨I型胶原吡啶交联终肽（ICTP）在评价强直性脊柱炎（AS）临床疗效中的作用。方法西安市第五医院2008年5月～2011年12月门诊及住院确诊的AS患者119例为痰病组，均符合1984年修订的“纽约（NY）”诊断标准，与50例正常对照组进行HLA—B27（磁珠酶免法）和血清ICTP（ELLSA法）浓度对照研究；并将119例AS患者按骶髂关节X线检查分为。级42例，I级19例，Ⅱ级15例，Ⅲ级25例和Ⅳ级18例给予醋氯芬酸片0．1g2次／天，柳氮磺胺吡啶肠溶片1．0g3次／天，甲氨蝶呤片7．5mg／周，叶酸片10mg3次／天联合治疗3个月后再次检测血清ICTP浓度，对比分析治疗前后血清ICTP浓度的变化。结果治疗前HLA-B27阳性组（n=77，11．06±4．88ng／m1）与HLV—B27阴性组（n=42，8．73±5．70ng／ml）的ICTP浓度经统计学分析差异无统计学意义（t=1．38，P〉0．05）。治疗前0，Ⅰ，Ⅱ，Ⅲ，Ⅳ级ICTP浓度（8．67±5．45，14．87±8．38，10．13±5．28，11．06土8．88，6．52±2．27ng／m1）明显高于正常对照组（3．59±1．97ng／ml；t：3．08，4．74，3．25，3．61和2．76，P〈0．01）。治疗前I，Ⅱ和Ⅲ级ICTP浓度较。级显著升高（t=3．14，2．33和2．41，P〈0．01或P〈0．05）；而Ⅳ级ICTP浓度较0级已显著下降（t=2．15，P〈0．05）。As患者骶髂关节炎X线0，Ⅰ和Ⅱ级治疗后较治疗前ICTP浓度显著下降（t=3．27，2．17和3．48，P〈0．01或P〈0．05），而Ⅲ，Ⅳ级差异无统计学意义（t=1．68和0．13，P〉0．05）。结论ICTP能够较好地评价As患者的临床疗效，特别是对早期AS患者的疗效评价更有意义。

Objective To explore role of ICTP in evaluating clinical effect of Akylosing Spondylitis（AS）. Methods It was re- spectively study that the serum ICTP and HLA-B27 of confirmed 119 cases of AS patients in inpatient and outpatient and 50 normal persons from May 2008 to December 2011 in the Fifth Hospital of Xi＇an, as well as ICTP concentration in AS pa- tients of 0, Ⅰ,Ⅱ,Ⅲ and Ⅳ class was analyzed in before-treatment and after-treatment. All patients were treated with methotrexate. The atmosphere of vinegar acid chloride and sulfasalazine. Results Concentration of ICTP was not different be- tween HLA-B27 positive and HLA-B27 negative （t= 1.38,P〉0. 05）. Concentration of ICTP in AS patients of 0, Ⅰ,Ⅱ,Ⅲ and ,Ⅳ class was respectively higher than healthy persons（t= 3.08,4. 74,3.25,3.61 and 2.76, P〈0.01） before treatment. Concentration of ICTP in AS patients of Ⅰ,Ⅱ and Ⅲ class was higher than 0 AS patients（t= 3.14,2.33 and 2.41, P〈0.01 or P〈0. 05） ,but it decreased obviously in 1V AS patients （t=2.15 ,P〈0. 05）. Concentration of ICTP in AS patients of 0, Ⅰ and Ⅱ class reduced remarkablely （t=3. 27,2.17 and 3.48,P〈0.01 or P〈0.05） after treatment. It did not reduce sig- nificantly in Ill, IV AS patients （t=l. 68 and 0.13,P〉0. 05）. Conclusion The ICTP is able to better evaluate the clinical treating effect, specially in the early.