类风湿性关节炎患者血清胱抑素C水平变化及其临床意义

Change and Clinical Significance of the Level of Serum Cystatin C in Patients with Rheumatoid Arthritis

目的 探讨类风湿性关节炎（RA）患者血清胱抑素C（CysC）水平变化及其临床意义.方法 选择2011年6月～2012年12月间铜陵市立医院收治的RA患者41例,根据28个关节疾病活动性评分（DAS28）,将RA患者分为活动组26例和缓解组15例,另选择同期体检健康者30例作为健康对照组,采用免疫比浊法检测血清CysC,同时检测类风湿因子（RF）、C反应蛋白（CRP）、唾液酸 （SA）、尿素（Urea）和血肌酐（SCr）,用魏氏法检测红细胞沉降率（ESR）,并根据性别、年龄、SCr按公式计算肾小球滤过率（eGFR）,并对各组结果进行统计学分析.结果 RA活动组血清CysC水平（1.19±0.48 mg/L）明显高于RA缓解组（0.74±0.16 mg/L）和健康对照组（0.73±0.17 mg/L）,差异有统计学意义（t=3.504,4.911,均P〈0.05）;RA缓解组血清CysC水平高于健康对照组,但差异无统计学意义（t=0.190,P〉0.05）.RA缓解组Urea,eGFR低于健康对照组和RA活动组,健康对照组Urea,eGFR又低于RA活动组;RA活动组SCr低于RA缓解组和健康对照组,RA缓解组SCr又低于健康对照组,但组间Urea,SCr和eGFR差异均无统计学意义（t=-1.637～1.343,均P〉0.05）.RA患者血清CysC与RF,CRP,SA,ESR,DAS28均呈正相关（r分别为0.361,0.369,0.346,0.325和0.503,P〈0.05,P〈0.01）.结论 血清CysC水平与RA病情活动状态有关,其可作为RA关节炎性活动及治疗后病情缓解的观察指标.

Objective To investigate the clinical significance of change of the level o{ serum cystaun C（CysC） in patients with rheumatoid arthritis（RA）. Methods 41 patients with RA and 30 healthy individuals were selected in Tongling municipal hospital from June 2011 to December 2012. Patients with RA were divided into the activity group （n=26） and the remission group （n=15） according to 28 joint disease activity score （DAS28）. Serum CysC by immunonephelometry method,rheuma-toid factor （RF）,C reaction protein （CRP）,sialic acid （SA）,Urea and serum creatinine （SCr） were measured by automatic biochemistry analyzer. Erythrocyte sedimentation rate （ESR） was measured by Westergren method. Estimated glomerular filtration rate （eGFR） was estimated according to gender, age, SCr. The data from different groups were analyzed statistical-ly. Results The level of serum CysC in the activity group （1.19 ± 0.48 mg/L） was higher than in the remission group （0.74±0. 16 mg/L） and the control group （0.73±0.17 mg/L） （t=3. 504,4. 911 ,P〈0.05） ,while there were no significant differences between the remission group and control group （t=0. 190, P〉0.05）. Urea and eGFR in the remission group were lower than in the control group and in the activity group,and Urea and eGFR in the control group were lower than in the activity group. SCr in the activity group was lower than in the remission group and in the control group,and SCr in the remission group was lower than in the control group. But Urea,SCr, eGFR were not statistically significant between any two in each group （t=-1. 637 - 1. 343, all P〉0. 05）. The level of serum CysC was positively correlated with RF, CRP, SA, ESR and DAS28 in patients with RA （r= 0. 361,0. 369,0. 346,0. 325 and 0. 503, P〈0.05 or P〈0.01）. Conclusion The level of serum CysC may correlate with the activity of patients with RA,which indicate that serum CysC may be used as an important index to evaluate the activity in patients with RA.