PTX-3在干燥综合征患者中的表达水平及其临床意义

Expression and clinical significance of serum pentraxin 3(PTX-3) in patients with Sjogren's syndrome

目的 ：探讨正五聚素-3（pentraxin 3,PTX3）在干燥综合征中的临床意义。方法 ：ELISA方法检测52例干燥综合征患者和15例健康体检者血浆PTX3水平,并分析了PTX3与干燥综合征患者临床指标的相关性。结果：1血浆PTX3水平变化：干燥综合征患者血浆PTX3水平[（1.492±0.018）ng/m L]显著高于健康对照组[（1.403±0.019）ng/ml],其中肾小管功能异常患者血浆PTX3水平[（1.573±0.019）ng/m L]显著高于无肾小管功能异常患者[（1.418±0.003）ng/m L]（P〈0.01）。2在干燥综合征合并肾小管功能异常的患者中,血浆PTX3水平与尿可滴定酸及尿铵离子水平呈显著负相关（P〈0.05）,而与炎症相关指标C反应蛋白、血沉无明显相关性,与免疫学指标Ig A、Ig G、Ig M、SS相关抗体、类风湿因子无相关关系。3对于干燥综合征合并肾小管功能异常的诊断效能PTX3与尿β2微球蛋白相当,PTX的ROC曲线下面积（AUC）为0.702（95%CI：0.593~0.811）,与尿β2微球蛋白（AUC：0.705,95%CI：0.567~0.843）无明显差异。结论：PTX3可能作为干燥综合征患者肾小管间质损伤的生物学标志物。

Objective：To explore the diagnostic significance of pentraxin 3（PTX3） in patients with Sjogren＇s syndrome（SS）.Methods：Plasma from 52 patients with SS and 15 healthy volunteers was detected for the level of PTX3 by ELISA. Correlation between PTX3 and clinical indexes of the patients with SS was analyzed. Results：Level of PTX3 in SS patients especially with tubular damage patients[（1.492 ± 0.018）ng/m L]was significantly higher than that in the control group[（1.403 ± 0.019）ng/m L]（P〈0.01）,and the plasma level of PTX3 [（1.573 ± 0.019）ng/m L]of patients（n =31）with renal tubular dysfunction（including abnormal urine acidification function,urine NAG and abnormal urinary β2-microglobulin）was significantly higher than that in patients without tubular damage [（1.418 ± 0.003）ng/m L]（P〈0.01）. Plasma PTX3 was negatively correlated with TA and NH4＋in the urine of SS with tubular damage（P〈0.05）. However,there was no correlation between ESR,CRP,Ig G,Ig A,Ig M,SSA,SSB,and RF. Efficacy of PTX3 in the diagnosis of renal tubular dysfunction in patients with SS was equivalent to that of urinary β2-microglobulin. The area under ROC curve of PTX3 was 0.702（95%CI：0.593~0.811）,which had no difference compared with urinary β2-microglobulin[AUC：0.705,95%CI：0.567~0.843]. Conclusion：Plasma PTX3 could be a useful marker of tubular damage in SS patients.