血管生成素2与抗中性粒细胞胞浆抗体相关性血管炎活动的关系

The relationship between angiopoietin-2 and anti-neutrophil cytoplasmic antibody-associated vasculitis activity

目的本研究旨在探讨血管生成素2(angiopoietin-2,Ang2)与抗中性粒细胞胞浆抗体(anti-neutrophil cytoplasmic antibodies,ANCA)相关性血管炎(ANCA-associated vasculitis,AAV)活动的关系。方法本研究纳入2012年5月~2016年5月间在我院住院的AAV患者共52例,所有AAV患者行伯明翰系统性血管炎活动评分(BVAS),选取BVAS<3分为非活动组,BVAS≥3分为活动组,选取我院同期健康体检者20名作为健康对照组。收集AAV患者血清,检测Ang2、血沉(ESR)、C反应蛋白(CRP)、循环内皮细胞(CECs)等,对Ang2水平与血清学指标进行相关性分析。用特征性曲线(ROC)及曲线下面积(AUC)对Ang2、CRP及ESR区分活动期及非活动期的准确度进行评价。结果活动组患者的血Ang2、ESR、CRP、CECs及BVAS评分较非活动组患者明显升高,差异有统计学意义(P<0.05)。Ang2水平与24 h尿总蛋白(r=0.461,P<0.05)、BVAS(r=0.745,P<0.05)、CECs(r=0.657,P<0.05)分别呈正相关。ROC分析显示Ang2的曲线下面积明显高于CRP和ESR,用外周血Ang2的浓度来区分AAV患者的非活动组与活动组准确度明显高于ESR和CRP(P<0.05)。结论 Ang2不仅可以作为ANCA相关性血管炎活动性的指标,还有望成为一些内皮细胞疾病的靶向治疗药物。

Objective To investigate the relationship between angiopoietin-2(Ang2) and anti-neutrophil cytoplasmic antibodies(ANCA) ANCA-associated vasculitis(AAV) activity. Methods A total of 52 AAV patients who were hospitalized in our hospital from May 2012 to May 2016 were enrolled in the study. All AAV patients were given Birmingham systemic vasculitis activity score(BVAS). The patients with BVAS <3 were divided into the non-active group,and the patients with BVAS≥3 were divided into the active group. 20 healthy volunteers who received physical examination in our hospital were selected as the healthy control group. The serum of AAV patients was collected, and Ang2,ESR, C-reactive protein(CRP), circulating endothelial cells(CECs) were detected. Correlation analysis was carried out on Ang2 level and serological parameters. The accuracy of Ang2, CRP and ESR in differentiating the active and nonactive phases was evaluated by the ROC and AUC. Results The levels of Ang2, ESR, CRP, CECs and BVAS scores in the active group were significantly higher than those in the non-active group, and the differences were statistically significant(P <0.05). Ang2 level was correlated with 24 h urinary total protein(r=0.461, P<0.05), BVAS(r=0.745,P<0.05) and CECs(r=0.657,P<0.05). ROC analysis showed that the AUC of Ang2 was significantly higher than CRP and ESR. The accuracy of the concentration of Ang2 in peripheral blood in differentiating the active and non-active group was significantly higher than that in ESR and CRP in AAV patients(P<0.05). Conclusion Ang2 can not only serve as an indicator of the activity of ANCA-associated vasculitis, but also is expected to be the drug of targeted therapy for some endothelial cell diseases.