髓样相关蛋白8/14在痛风急性发作期的表达

Expression of Myeloid-Related Protein 8/14 in Acute Attack of Gout

目的：探讨外周血髓样相关蛋白8／14（myeloid—related protein 8／14，MRP8／14）对痛风急性发作的诊断价值及对后续治疗的指导意义。方法：选取门诊就诊的痛风急性发作患者40例、痛风间歇期患者24例以及健康体检志愿者12例；采用酶联免疫吸附法（enzyme-linked immunosorbent assay，ELISA）定量检测血清MRP8／14水平，其中32例急性期患者在症状缓解前后均行测定。结果：痛风急性发作患者血清MRP8／14水平高于间歇期患者及健康体检者（P〈0．01）；急性发作患者症状缓解后MRP8／14水平低于发作期（P〈0．01）；间歇期患者MRP8／14水平与健康体检者比较差异无统计学意义（P〉0．05）；MRP8／14水平与血沉（erythrocyte sedimentation rate，ESR）及高敏C-反应蛋白（high—sensitivity C-reactive protein，hs—CRP）无明显相关性。根据受试者工作特征（receiver operating characteristic，ROC）曲线得出，MRP8／14诊断痛风急性发作的最佳分界值（cut-off值）为504．00mg／L，ROC曲线下面积为0．852（95％CI：0．770-0．934），灵敏度和特异度分别为77．5％、77．8％。结论：MRPS／14在痛风急性发作期升高，且独立于ESR及hs—CRP水平，而MRP8／14在间歇期患者中的表达水平接近于健康人，可作为急性发作的生化标志物。

Objective：To investigate the value of myeloid-related protein 8/14 （MRP8/14） in the diagnosis and following treatment of acute attack of gout. Methods： A total of 40 patients with gout in acute attack, 24 patients with gout in intermission and 12 healthy people were enrolled. MRP8/14 expression was tested by enzyme-linked immunosorbent assay（ELISA）. Results： MRP8/14 level in patients with gout in acute attack was higher than those in intermission and healthy people （P〈0.01）. MRP8/14 showed significant reduction after treatment, compared with acute attack period（P〈0.01）. MRP8/14 level had no significant difference between patients with gout in intermission and healthy people （P〉0.05）. MRP8/14 was not related to the level of erythrocyte sedimentation rate（ESR） or high-sensitivity C-reactive protein（hs-CRP）. Receiver operating characteristic （ROC） curve analysis was used to determine the cut-off value of this assay for identifying individuals with acute attack. The sensitivity and specificity at the optimal cut-off value of 504.00 mg/L were 77.5% and 77.8%. The area under ROC curve was 0. 852（95 %CI：0. 770-0. 934）. Conclusions： MRP8/14 expression increases in acute attack of gout, and it is not relevant to ESR or hs-CRP. MRP 8/14 expression decreases after symptom remission. MRP8/14 can be regarded as a biochemical marker for acute attack of gout.