强直性脊柱炎患者血清骨保护素水平及临床意义

Serum osteoprotegerin level and its clinical significance in patients with ankylosing spondylitis

目的通过检测骨保护素(OPG)在强直性脊柱炎(AS)患者外周血的表达,探讨OPG在AS患者中的临床意义。方法选取已确诊AS患者48例,其中HLA-B27阳性者34例。分析OPG与人体白细胞抗原B27(HLA-B27)、性别、年龄与病程的相关性。每周2次予依那西普25mg皮下注射治疗,在0、2、6、12周随访时检测OPG,同时测定红细胞沉降率(ESR)与血清C-反应蛋白(CRP)等炎症指标。结果 OPG水平与HLA-B27及性别相关(P<0.05),与扩胸度成正相关(P<0.05),与其余临床指标呈负相关(P<0.05)。依那西普治疗后,OPG水平升高,而ESR、CRP等炎症指标下降。结论肿瘤坏死因子-α(TNF-α)拮抗剂依那西普可减轻患者的炎症反应,上调血清OPG水平,改善患者体征。依那西普阻止AS骨量丢失,调节骨代谢的靶点可能是OPG信号通路。

Objective To detect the osteoprotegerin（OPG）in peripheral blood of ankylosing spondylitis（AS）patients and explore the significance of OPG in AS patients.Methods48 patients diagnosed with AS were selected.Among them,34 patients had positive HLAB27.The correlation analysis of OPG and human leukocyte antigen B27（HLA-B27）,gender,age and course of the disease were conducted.Patients were treated with subcutaneous injection of TNF-α antagonist etanercept 25 mg twice weekly.The OPG level was detected at follow up in 0,2,6,12 weeks.Meanwhile,the inflammatory markers of erythrocyte sedimentation rate（ESR）and serum C-reactive protein（CRP）levels were determined.Results The serum OPG level was obviously relative to HLA-B27 and gender of patients（P0.05）.OPG level had a positive correlation with chest expansion degree（P0.05）anda negative correlation with other clinical indicators of AS（P0.05）.The OPG level was up-regulated after treatment of etanercept and the erythrocyte sedimentation rate（ESR）and serum C-reactive protein（CRP）levels were down-regulated.Conclusion TNF-α antagonist etanercept can reduce the inflammation in AS patients,increase the serum OPG level and improve the physical sign of AS patients.The target for etanercept preventing bone loss and regulating bone metabolism in AS patients may be OPG signaling pathways.