NGAL对类风湿性关节炎及其活动度判定的临床价值浅析

A Clinical Perspective of NGAL for Diagnosis and Activity Assessment of Rheumatoid Arthritis

目的对中性粒细胞明胶酶相关脂质运载蛋白(neutrophilgelatinaseassociatedlipocalin,NGAL)在类风湿性关节炎(RA)患者血液与滑液中的表达规律进行初步分析,探讨其在RA诊断与活动性判定时的临床应用前景。方法病例资料来自新疆维吾尔自治区人民医院,采集60例RA患者与60例正常对照人群血液样本,RA患者按疾病活动度进行分组,另采集RA患者的滑液标本,检测其血液与滑液NGAL含量,血液与滑液NGAL水平均采用胶乳增强免疫比浊法进行检测。结果 RA患者和正常人群血液NGAL(μg/L)分别为375.3±166.4和70.9±10.1,活动期和缓解期患者NGAL(μg/L)分别为512.1±128.7和239.2±43.5,以RA患者高于正常人群,且活动期高于缓解期RA患者,差异均具有统计学意义;RA患者NGAL水平与炎症指标TNF-α、IL-6和CRP均呈正相关;RA患者血液与滑液NGAL水平具有相关性,不同活动度RA患者之间也具有相关性。结论 NGAL在RA患者与正常人群中表达差异有统计学意义,具有良好的疾病相关性,在诊断与指导RA治疗时具有良好的应用前景。

Objective To investigate the expression patterns of neutrophil gelatinase-associated lipocalin（NGAL） in sera and synovial fluids of rheumatoid arthritis（RA）patients. Method We collected blood and synovial fluid samples from 60 RA patients and 60 normal persons as control in Xinjiang Peoples＇ Hospital. The RA patients were divided into two groups by DAS28 scores. Synovial fluid samples were collected from RA patients,and NGAL was detected by latex particleenhanced turbidimetric immunoassay. Results The serum NGAL levels were（375.3±166.4） μg/L in RA patients,（512.1±128.7） μg/L in the patients with activity phase,（239.2±43.5） μg/L in those with alleviated phase,and（70.9±10.1） μg/L in control group. The NGAL level was significantly higher in the patients than that in the control,and statistically higher in the patients of activity phase than those of alleviated victims. The NGAL level was also correlated with increased inflammation cytokines such as TNF-α,IL-6 and CRP in RA patients. Additionally,pNGAL production was positively correlated with sfNGAL level in RA patients. Conclusion NGAL showed a distinct difference between RA patients and normal individuals and NGAL expression has a close correlation with the disease activity,suggesting that NGAL could be a potential marker for the diagnosis and therapy management of rheumatoid arthritis.