血清铁蛋白在痛风急性发作期的临床价值

Clinical value of serum ferritin level in acute gout attack

目的:探讨血清铁蛋白(SF)在痛风急性发作期作为监测炎症活动及疗效指标的临床价值。方法:回顾2013年10月~2019年6月在弋矶山医院住院的急性发作期痛风患者,共筛选出符合入选条件的痛风患者98例。其中10例患者在治疗后进行了相关研究指标的复查。首先比较SF正常与SF升高患者在病程、尿酸、肌酐、血沉(ESR)及C反应蛋白(CRP)水平的差异,分析SF水平分别与ESR、CRP及尿酸水平的相关性。其次对比治疗前后SF、ESR及CRP水平的变化。结果:SF升高患者的ESR及CRP水平均高于SF正常患者(P<0.01),而两组在病程、尿酸及肌酐上差异均无统计学意义(P>0.05)。痛风患者SF水平与ESR(rs=0.535)及CRP(rs=0.448)均呈正相关(P<0.001),而SF水平与尿酸(rs=-0.053)相关性无统计学意义(P>0.05)。痛风患者治疗后SF、ESR和CRP均较治疗前下降,差异有统计学意义(P<0.05)。结论:在痛风急性发作期,SF可以与传统炎症监测指标一起作为疾病活动和抗炎疗效监测的有效指标。

Objective:To investigate the clinical value of serum ferritin(SF)level as an indicator for evaluating inflammatory activity and anti-inflammatory efficacy in gout during acute attack.Methods:Cases of acute gout attacks admitted to our hospital were initially reviewed from October 2013 to June 2019.Of the 98 eligible patients,10 underwent repeated measurement of related observation indexes after treatment.The difference was compared between normal SF group and elevated SF group concerning the disease course,levels of uric acid,creatinine,erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)for examination of the relationship between SF and ESR and CPR,and then the change of SF level and ESR and CPR level was compared before and following therapy.Results:The level of ESR and CRP was higher in patients with elevated SF than in those with normal SF level(P<0.01),yet the difference was insignificant in disease course and levels of uric acid and creatinine between the two groups(P>0.05).The level of SF and ESR was positively correlated with that of CRP in patients during gout attack(rs=0.535,rs=0.448,respectively,P<0.01),yet had no significant correlation with uric acid(rs=-0.053,P>0.05).Evidently reduced level of SF,ESR and CRP was seen in the patients after medication(P<0.05).Conclusion:Serum ferritin level can be used as an effective indicator together with routine inflammatory markers for estimating thedisease activity and anti-inflammatory efficacy in patients with gout during acute attack.