血清铁蛋白对幼年特发性关节炎全身型活动性及预后判断的价值

Value of serum ferritin in measuring the activation and prognosis in systemic onset juvenile idiopathic arthritis

目的 研究血清铁蛋白（SF）与全身型幼年特发性关节炎（SOJIA）疾病活动性是否相关,能否根据SF在SOJIA病程中的变化初步判断疾病活动性及预后.方法 选取2005年9月至2012年12月北京儿童医院风湿免疫科SOJIA患儿92例,其中合并巨噬细胞活化综合征（MAS）25例,多关节型幼年特发性关节炎（JIA）33例,少关节型JIA 30例.同时选取健康儿童47名及急性感染性疾病患儿30例分别作为正常对照组和感染对照组.用化学发光法分别对所有对象血样本进行SF检测.JIA各组及感染组同时检测白细胞、血红蛋白、血小板、C反应蛋白及红细胞沉降率.SOJIA缓解期复查上述指标.将结果进行统计学分析.结果 活动期SOJIA患儿SF水平（555±2037） g/L,明显高于正常对照组、感染对照组及其他类型JIA,均P＜0.01;缓解期SF明显下降.并发MAS的SOJIA患儿SF水平为（12 707 ±6789） μg/L,显著高于未并发MAS的活动期SOJIA,差异有统计学意义.结论 SF水平与SOJIA活动性相关,对疾病活动性及预后判断有重要指导意义.

Objective To explore the correlation of serum ferritin （SF） and systemic onset juvenile idiopathic arthritis （ SOJIA ） so as to determine the prognostic values of SF for SOJIA. Methods All samples were collected from 92 juvenile idiopathic arthritis （JIA） patients at Beijing Children＇s Hospital between February 2005 to September 2012. Their age range was 2 - 15 years. There were macrophage activation syndrome （ MAS, n = 25） , polyarticular JIA （ n = 33 ） and oligoarticular JIA （ n = 30）. And 47 healthy children and another 30 with acute infective diseases were selected as control groups respectively. Blood samples were collected and SF was measured in different disease phases. Other parameters include leucocyte, hemoglobin, platelet, C-reactive protein and erythrocyte sedimentation rate. Statistics of SF level at different groups as well as at different disease phases were performed. Results The SF level of active phase SOJIA patients was significantly higher （ P 〈 0. 01 ） than that in Other groups. And its level in the active phase of SOJIA was significantly higher than that in patients during the recovery phase. The SF level in patients with MAS was significantly higher than that in those without MAS. Conclusion Correlated with the course of SOJIA, the level of SF may judge the disease activity and predict the outcomes of SOJIA.