类风湿关节炎患者血小板反应蛋白-1水平与疾病活动指标的相关性分析

Correlation analysis between serum thrombospondin-1 level and disease activity rheumatoid arthritis

目的测定老年及中青年类风湿关节炎（RA）患者血清中血小板反应蛋白-1（TSP-1）水平，评价TSP-1水平与老年RA（老年组）及中青年RA（中青年组）疾病活动指标的关系，为疾病的诊断及病情评估提供依据。方法RA患者98例，老年组33例，中青年组65例，另设健康对照组58例，应用ELISA方法检测血清中TSP-1水平，分析不同年龄组患者与健康对照组TSP-1水平的差异，分析TSP-1水平与老年／中青年RA患者压痛关节数、肿胀关节数、血沉、C反应蛋白水平、疾病活动性评分（DAS28）、类风湿因子（RF）水平、免疫球蛋白（IgG、IgA、IgM）等疾病活动指标的相关性。结果RA患者血清TSP1的水平明显高于健康对照（P〈0．01），TSP-1水平与RA肿胀关节数（r=0．246，P〈0．05）及DAS28评分相关（r=0．241，P〈0．05）。老年RA患者TSP-1水平与关节肿胀数相关（r=0．377，P％0．05）；中青年RA患者TSP-1水平与DAS28评分（r=0．243，P〈0．05）及RF水平相关（r=0．326，P〈0．05）。结论TSP-1水平是提示RA疾病活动新的血清学标记物，对老年RA患者的病情评估具有重要的意义。

Objective To detect serum level of thrombospondin-1 （TSP-1） in rheumatoid arthritis （RA） patients, and analyze the correlation between serum TSP-1 level and disease activity in elderly versus young and middle-aged RA patients in order to provide the basis for diagnosis ahd evaluation of RA. Methods Peripheral blood was collected from 98 RA patients （including 33 elderly, 65 young and middle-aged RA patients） and 58 healthy controls. Serum TSP-1 levels were detected by enzyme-linked immunosorbent assay （ELISA）. Difference in TSP-1 level between RA patients and healthy controls was analyzed. Correlations of TSP-1 level with disease activity parameters of number of tender joints and swelling joints, disease activity score （DAS28 score） and erythrocyte sedimentation rate （ESR）, levels of C-reactive protein （CRP）, rheumatoid factor （RF）, immunoglobin G （IgG）, immunoglobin A （IgA） and immunoglobin M （IgM） were analyzed in elderly versus young and middle-aged RA patients. Spearman＇s and Pearson＇ s correlation analysis were performed. Results TSP-1 level was significantly higher in RA patients than in healthy controls （P 〈0.01）. TSP-1 level was correlated with number of swelling joints and DAS28 score in RA patients （r=0. 246 and 0. 241, both P〈0.05）. In elderly RA patients, TSP-1 level was correlated with number of swelling joints （ r= 0. 377, P〈0.05）, meanwhile significantly positive correlations of TSP- 1 level with DAS28 score and rheumatoid factor level were observed in young and middle-aged RA patients （r= 0. 243 and 0. 326, both P〈 0.05）. Conclusions TSP-1 may play roles in the development of RA and its determination may benefit evaluating disease activity. In elderly RA patients, TSP-1 level may reflect severity of rheumatoid arthritis and may be a novel biomarker to the evaluation of disease severity.