强直性脊柱炎患者血清Dickkopf-1、抗酒石酸酸性磷酸酶5b的意义

Dickkopf-1 and Tartrate-Resistant Acid Phosphatase 5b in Ankylosing Spondylitis

目的：通过测定强直性脊柱炎（AS）患者血清Dickkopf-1（DKK-1）、抗酒石酸酸性磷酸酶5b（TRACP-5b）的水平，分析AS各项临床指标与DKK-1、TRACP-5b的相关性，探讨AS骨结构损伤的特点。方法记录30例AS患者的年龄、性别、病程、HLA-B27及治疗前后晨僵、脊柱痛、枕壁距、指地距、血沉（ESR）、C反应蛋白（CRP）、Bath AS疾病活动指数（BASDAI）、骶髂关节CT分级，以酶联免疫吸附法（ELISA）测定研究对象血清DKK-1、TRACP-5b的水平，对比AS患者与健康对照组血清DKK-1、TRACP-5b水平的差异，并分析其与AS各项临床指标的相关性。结果1.AS患者的血清DKK-1、TRACP-5b水平分别为819.65±204.56 pg/mL、3.9393±1.3354 U/L，均低于健康对照组（1591.50±335.92 pg/mL、8.6379±1.9148 U/L），差异有统计学意义（P＜0.05）；2.早期AS患者血清DKK-1、TRACP-5b水平分别为1186.00±493.70 pg/mL、5.9150±2.9282 U/L，均高于中晚期AS患者（636.60±181.04 pg/mL、2.9614±1.3772 U/L），但差异无统计学意义（P＞0.05）；3.AS患者血清DKK-1、TRACP-5b均与患者骶髂关节CT分级呈负相关（P＜0.05），与其他临床指标均不相关；4.AS患者血清DKK-1、TRACP-5b呈正相关（P＜0.0001）。结论DKK-1、TRACP-5b在AS骨结构损伤发生中可能起了一定的作用。

Objective To detect the serum levels of dickkopf-1 （DKK-1） and tartrate-resistant acid phosphatase 5b （TRACP-5b） in patients with ankylosing spondylitis （AS） and investigate the possible role of DKK-1 and TRACP-5b in structural damage of AS. Methods ELISA was used to detect the levels of DKK-1 and TRACP-5b. The core indicators of AS were evaluated to contrast the serum levels of DKK-1 and TRACP-5b in two groups and analyze the relevance of DKK-1, TRACP-5b and the core indexes of AS. Results 1.The levels of serum DKK-1 and TRACP-5b in AS were 819.65±204.56 pg/mL and 3.9393±1.3354 U/L, significantly lower than which in control group （1591.50±335.92 pg/mL and 8.6379±1.9148 U/L, P〈0.05）;2.The levels of serum DKK-1 and TRACP-5b of early AS were 1186.00±493.70 pg/mL and 5.9150±2.9282 U/L, higher than that of medium and late AS （636.60±181.04 pg/mL and 2.9614±1.3772 U/L）, but there was no significance between them （P〉0.05）;3.The levels of serum DKK-1 and TRACP-5b were both negatively correlated with the radiographic stage in patients with AS （P〈0.05）;4.There was positive correlation between the level of serum DKK-1 and TRACP-5b in patients with AS （P〈0.0001）. Conclusion DKK-1 and TRACP-5b may play role in AS.