血清淀粉样蛋白A(SAA)升高的大动脉炎(TA)患者免疫炎症状态

Inflammatory state of patients with Takayasu's arteritis(TA) complicated with elevated serum amyloid A(SAA)

目的对伴有血清淀粉样蛋白A(serum amyloid A,SAA)升高的大动脉炎(Takayasu’s arteritis,TA)患者的临床特征、免疫炎症状态和疾病活动性进行分析。方法收集TA患者80例,比较SAA升高组和正常组患者一般资料、病情活动、炎症指标、细胞因子及用药情况差异,采用t检验、秩和检验和Spearman’s相关系数分析进行统计学分析。结果与SAA正常组相比,SAA升高组有更多患者Kerr评分≥2(86.44%vs.61.9%,P=0.036),红细胞沉降率(erythrocyte sedimentation rate,ESR)[(47.84±34.60)mg/L vs.(18.86±15.87)mg/L,P<0.001]、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)[17.42(5.20～36.90)mg/L vs.1.80(0.75～4.05)mg/L,P<0.001]、血小板数[(295.00±95.60)×109/L vs.(240.85±75.78)×109/L,P=0.025]、血清球蛋白水平[(29.05±6.49)g/L vs.(24.98±4.33)g/L,P=0.002]、IgG[(13.37±4.52)g/L vs.(11.63±2.63)g/L,P=0.048]、补体C3[(1.26±0.26)g/L vs.(1.03±0.20)g/L,P=0.002]、C4[0.25(0.21～0.29)g/L vs.0.20(0.14～0.23)g/L,P=0.008]及IL-6水平[(10.64±8.93)pg/mL vs.(3.88±2.72)pg/mL,P=0.001]显著高于SAA正常组。结论 SAA升高的TA患者炎症指标和疾病活动性更高,SAA检测有助于了解炎症和疾病状况。

Objective To analyze the clinical feature,inflammatory state and disease activity of patients with Takayasu’s arteritis(TA)complicated with elevated serum amyloid A(SSA). Methods Among80 TA patients,the differences in clinical data,disease activity,inflammatory markers,cytokines and drug utilization were compared between SAA-elevating group and SAA-normal group by t test,rank sum test and Spearman’s correlation analysis. Results SAA-elevating group had higher portion of Kerr’s index≥2(86.44%vs.61.9%,P=0.036),higher level of erythrocyte sedimentation rate(ESR)[(47.84±34.60)mg/Lvs.(18.86±15.87)mg/L,P<0.001]and high sensitivity C-reactive protein(hs-CRP)[17.42(5.20-36.90)mg/L vs.1.80(0.75-4.05)mg/L,P<0.001],platelet[(295.00±95.60)×109/Lvs.(240.85±75.78)×109/L,P=0.025],globulin[(29.05±6.49)g/Lvs.(24.98±4.33)g/L,P=0.002],IgG [(13.37±4.52)g/L vs.(11.63±2.63)g/L,P=0.048],C3[(1.26±0.26)g/L vs.(1.03±0.20)g/L,P=0.002],C4 [0.25(0.21-0.29)g/L vs.0.20(0.14-0.23)g/L,P=0.008]and IL-6[(10.64±8.93)pg/mL vs.(3.88±2.72)pg/mL,P=0.001]compared with SAA-normal group. Conclusions TA patients complicated with elevated SSA have higher inflammatory index and disease activity,thus examination of SAA is necessary to reveal the inflammatory and disease status.