类风湿性关节炎患者血清胆红素水平的变化及临床意义

Changes and clinical significance of serum bilirubin level in rheumatoid arthritis

目的探讨类风湿性关节炎(RA)患者血清胆红素水平的变化及临床意义。方法选取RA患者180例,其中活动组101例和非活动组79例,同时选取90例健康者为正常对照组,比较各组血清胆红素水平的差异,采用Logistic回归分析血清胆红素水平与RA疾病活动性的关系。结果与对照组相比,RA非活动组和RA活动组血清胆红素水平降低,并且RA活动组血清胆红素水平低于RA非活动组,差异均有统计学意义(P <0. 05); Logistic回归分提示血清胆红素水平[OR=0. 408(95%CI:0. 285～0. 614),P <0. 05]是RA疾病活动的独立影响因素; ROC曲线分析发现,血清胆红素水平的曲线下面积为0. 779(95%CI:0. 709～0. 848,P <0. 01),但其最佳临界值为7. 97μmol/L时,血清胆红素水平评估RA疾病活动性的灵敏度为81. 40%,特异度为67. 50%。结论血清胆红素水平可以作为一种预测RA疾病活动的血清学指标,有一定的临床意义。

Objective To explore the changes and clinical significance of serum bilirubin level in rheumatoid arthritis.Methods A total of 180 patients with rheumatoid arthritis( RA) were divided into patients with RA activity( n = 101) and non RA activity( n = 79). 90 healthy people were also enrolled in our study as the control group. The differences in serum bilirubin levels were compared between the groups. Logistic regression was used to analyze the relationship between serum bilirubin levels and RA disease activity. Results Compared with the control group,serum bilirubin level in the RA activity group and the non RA activity group decreased,and that in the RA activity group was lower than that in the non RA activity group,with the differences statistically significant( P < 0. 05). Logistic regression analysis showed that serum bilirubin level( OR = 0. 408,95% CI: 0. 285-0. 614,P < 0. 05) was an independent factor for RA activity. According to ROC curves,the area under the curve of serum bilirubin levels was 0. 779( 95% CI: 0. 709-0. 848,P < 0. 01); when the optimal cut-off value was7. 97 μmol/L,the sensitivity of serum bilirubin level to assess the activity of RA disease was 81. 40% and the specificity was67. 50%. Conclusion Serum total bilirubin level may be a mark for predicting the disease activity of RA.