颗粒蛋白前体与类风湿性关节炎的关系

Relationship between progranulin and rheumatoid arthritis

目的探讨血清及关节液颗粒蛋白前体(progranulin,PGRN)水平在类风湿性关节炎(rheumatoid arthritis,RA)诊断与鉴别诊断中的价值。方法 RA患者76例(RA组)、骨关节炎(osteoarthritis,OA)患者55例(OA组)以及体检健康者40例(对照组),检测各组血清PGRN水平以及RA组和OA组患者关节液中PGRN水平,并进行比较;采用ROC曲线计算PGRN诊断RA的灵敏度和特异度。结果 RA组血清PGRN[(55.2±11.1)μg/L]高于OA组[(45.4±6.6)μg/L]和对照组[(42.5±7.2)μg/L](P<0.01),OA组与对照组比较差异无统计学意义(P>0.05);RA组关节液PGRN水平[(69.1±4.8)μg/L]高于OA组[(36.3±10.1)μg/L](P<0.01);活动期RA患者血清及关节液中PGRN水平[(58.3±9.2)、(79.0±3.6)μg/L]高于非活动期患者[(50.2±10.9)、(63.3±4.0)μg/L](P<0.01);以OA和对照组为对照,血清PGRN诊断RA的灵敏度为84.2%,特异度为80.1%;以OA为对照,血清PGRN诊断RA的灵敏度为68.4%、特异度为70.9%,关节液PGRN诊断RA的灵敏度为73.7%、特异度为78.2%。结论血清及关节液PGRN水平对RA诊断与鉴别诊断有较好应用价值,可作为RA辅助诊断指标。

Objective To evaluate the value of progranulin level in serum and synovial fluid to the diagnosis and differential diagnosis of rheumatoid arthritis （RA）. Methods The serum progranulin levels in serum and synovial fluids were detected and were compared between 76 patients with RA （RA group） and 55 patients with osteoarthritis （OA） （OA group）, and another 40 healthy volunteers （control group） were only detected the serum progranulin level by ELISA. ROC was adopted to calculate the sensitivity and specificity. Results The progranulin levels in serum （（55.2±11.1） μg/L） and synovial fluid （（69. 1 ± 4. 8） μg/L） in RA group were significantly higher than those in OA group （serum： （45.4±6.6） μg/L, synovial fluid： （36.3±10.1） μg/L） and control group （serum： （42.5±7.2） μg/L） （P〈 0.01）, and there was no significant difference between OA group and control group （P〈0.05）. The progranulin levels in serum （（58.3 ± 9.2） gg/L） and synovial fluid （（79.0 ±3.6） μg/L） in patients with active RA were also significantly higher than those in patients with stable RA （serum： （50.2±10.9）μg/L, synovial fluid： （63.3±4.0） μg/L） （P〈 0. 01）. The sensitivity and specificity of serum progranulin for RA were 84. 2% and 80. 1X, 73. 7% and 78. 2% of synovial fluid progranulin for RA, and were 68.4% and 70.9% of serum progranulin for the differential diagnosis of RA from OA. Conclusion The detection of progranulin in serum and synovial fluid has a great value to the diagnosis and differential diagnosis of RA, which could be used as an auxiliary method for the diagnosis of RA.