血清软骨寡聚基质蛋白在幼年特发性关节炎中的临床意义

Serum cartilage oligomeric matrix protein in children with juvenile idiopathic arthritis and its clinical significance

目的探讨血清软骨寡聚基质蛋白(COMP)在早期预测幼年特发性关节炎(JIA)关节破坏中的临床意义。方法采用ELISA法测定并对比分析35例幼年特发性关节炎患儿(JIA组)急性期、缓解期及30例腹股沟斜疝修补术儿童(对照组)血清COMP水平的差异,同时将血清COMP水平与JIA患儿的各项临床指标进行相关性分析。结果 JIA患儿急性期血清COMP水平(0.77±0.29)ng/ml,明显低于缓解期[(1.12±0.28)ng/ml]和对照组[(1.33±0.37)ng/ml],差异均有统计学意义(均P<0.05)。全身型JIA血清COMP水平(0.26±0.03)ng/ml,明显低于少关节型JIA[(0.87±0.17)ng/ml]、与附着点炎症相关型关节炎[(0.89±0.22)ng/ml]及多关节型JIA[(0.70±0.35)ng/ml],差异均有统计学意义(均P<0.05)。JIA中存在关节破坏的患儿血清COMP水平(0.52±0 22)ng/ml,明显低于无关节破坏患儿[(0.92±0.22)ng/ml],差异有统计学意义(P<0.05)。JIA患儿急性期血清COMP水平与WBC、CRP、ESR呈负相关(r=-0.556、-0.582、-0.684,均P<0.05),与关节压痛指数、关节肿胀指数、晨僵、血红蛋白、血小板无相关(r=0.06、-0.206、-0.107、-0.319、-0.185,均P>0.05)。结论血清COMP水平在JIA患儿急性期、全身型JIA、关节破坏JIA患儿中明显下降,与炎症指标CRP、ESR、WBC呈负相关,可能成为JIA疾病活动、关节破坏、生长抑制的预测指标。

Objective To evaluate the clinical significance of serum cartilage oligomeric matrix protein in early prediction of joint damage with juvenile idiopathic arthritis （JIA）. Methods Serum cartilage oligomeric matrix protein （COMP） levels were measured by enzyme linked immunosorbent assay （ELISA） in 35 children with juvenile idiopathic arthritis （JIA） in acute phase or remission stage and 30 children with inguinal hernia （control group）. The correlation of serum COMP levels with clinical indicators of JIA patients was analyzed. Results Serum COMP level of JIA children in acute phase （0.77 ＆#177; 0.29ng/ml） was significantly lower than that of control group （1.33± 0.37 ng/ml, P〈0.05）. Serum COMP level of JIA children in acute phase was significantly lower than that in the recovery period （1.12±0.28ng/ml, P〈0.05）. Serum COMP level of systemic JIA （0.26±0.03 ng/ml） was significantly lower than that of oligoarticular JIA （0.87± 0.17 ng/ml）, enthesitis- related arthritis JIA （0.89± 0.22 ng/ml） and pol-yarticular JIA （0.70±0.35 ng/ml） （al P〈0.05）. The serum COMP levels of JIA with joint damage（0.52±0.22ng/ml）was signifi-cantly lower than those without joint destruction （0.92±0.22ng/ml, P＆lt;0.05）. The serum COMP levels of JIA children in acute phase were negatively correlated with WBC, CRP, ESR （r=- 0.556,- 0.582,- 0.684, P〈0.05）, not correlated with joint pain index, swel ing index, morning stiffness, hemoglobin, platelet（r=0.06,- 0.206,- 0.107,- 0.319,- 0.185, P〉0.05）. Conclusion The lev-els of serum COMP are decreased in JIA with acute phase, systemic JIA and JIA with joint damage, and are negatively correlat-ed with inflammatory markers, indicating that serum COMP might be a useful predictor of JIA activity, joint destruction and growth inhibition.