淀粉样蛋白A在骨关节炎患者血清中的表达及诊断价值

Expression and diagnostic value of serum amyloid A in patients with osteoarthritis

目的分析淀粉样蛋白A(SAA)在骨关节炎(OA)患者血清中的表达并探讨其诊断价值。方法收集2018年7月1日至2019年7月1日在浙江省台州医院首诊为OA61例、系统性红斑狼疮(SLE)83例、类风湿关节炎(RA)131例患者及体检健康人群139例(健康对照组)的临床信息及实验室检测数据。采用Kruskal-Wallis检验比较OA、SLE、RA患者及健康对照组血清SAA水平的差异,采用Spearman相关分析检测SAA与OA、SLE及RA的相关性,ROC曲线分析SAA对OA的诊断价值。结果SAA在OA患者中的表达显著高于SLE、RA患者及健康对照组,SAA与OA呈正相关(r=0.472,P<0.001)。以健康对照组为对照,SAA诊断OA的AUC为0.887(95%CI:0.829,0.946),最佳cut-off值为9 mg/L,灵敏度为0.820,特异度为0.877,阳性预测值为74.6%,阴性预测值为91.7%,以SLE和RA患者为对照,SAA诊断OA的AUC为0.748(95%CI:0.676,0.820),最佳cut-off值为37 mg/L,灵敏度为0.607,特异度为0.808,阳性预测值为47.4%,阴性预测值为87.8%。结论OA患者血清中SAA表达上调,且SAA与OA呈正相关,SAA可作为OA有效筛查和鉴别诊断的实验室指标。

Objective To investigate the expression and diagnostic value of serum amyloid A(SAA)in patients with osteoarthritis(OA).Methods Clinical information and laboratory test data of patients with OA,systemic lupus erythematosus(SLE),rheumatoid arthritis(RA)and healthy subjects were collected from Taizhou Hospital.The difference of SAA in OA,SLE,RA patients and healthy subjects was detected by Kruskal-Wallis test,and the correlation of SAA with OA,SLE,RA was examined by bivariate correlation analysis,and the diagnostic value of SAA in OA was analyzed by ROC curve.Results SAA expression in OA was significantly higher than that in SLE,RA patients and healthy controls.SAA was positively correlated with OA(r=0.472,P<0.001).With healthy subjects as controls,the area under the curve(AUC)of SAA for diagnosis of OA was 0.887(0.829,0.946);taking 9 mg/L as cut-off value,the sensitivity was 0.820,the specificity was 0.877,the positive predictive value was 74.6%,and the negative predictive value was 91.7%.With SLE and RA as the controls,the AUC of SAA for diagnosis of OA was 0.748(0.676,0.820);taking 37 mg/L as cut-off value,the sensitivity was 0.607,the specificity was 0.808,the positive predictive value was 47.4%,and the negative predictive value was 87.8%.Conclusion SAA expression in serum of patients with OA is up-regulated,and SAA is positively correlated with OA disease,SAA can be used as an effective laboratory indicator for OA screening and differential diagnosis.