腺苷脱氨酶及同工酶对自身免疫病诊断和病情监测的作用

Effects of Adenosine Deaminase and Isozyme on Diagnosis and Disease Activity in Patients with Autoimmune Diseases

目的:检测腺苷脱氨酶(ADA)及其同工酶在自身免疫病患者血清中的变化,探讨其诊断和病情监测作用。方法:收集70例系统性红斑狼疮(SLE)、114例类风湿性关节炎(RA)、55例强直性脊柱炎(AS)、及其年龄性别对应的健康血清标本。测定血清总ADA(t ADA)、ADA1及ADA2活性。ROC曲线分析其诊断价值。结果:与健康对照相比,ADA活性在SLE患者血清中显著升高[t ADA:15(12,20)vs 8(7,10)U/L;ADA1:3.5(2,5)vs 3(2,3)U/L;ADA2:11(8,15)vs 6(5,7)U/L;(P<0.01)]。与健康对照相比,RA患者血清中t ADA和ADA1活性无显著变化(P>0.05),ADA2活性水平升高[8(5.25,10)vs 7(5,9)U/L,(P<0.05)];与健康对照相比,AS患者血清中t ADA和ADA1活性无显著变化(P>0.05),ADA2活性升高[7(5,9)vs 6(5,7)U/L,(P<0.05)]。ROC分析显示t ADA及ADA2对SLE具有较好诊断价值(t ADA:88.6%特异性、77.1%敏感性;ADA2:92.9%特异性、68.6%敏感性)。ADA活性对RA及AS患者无诊断价值。spearman相关性分析显示,t ADA活性与SLE患者疾病活动度有一定正相关性(r=0.303,P=0.011)。结论:血清t ADA活性检测可作为SLE辅助诊断和病情监测指标。

Objective: To investigate the changes and diagnostic value of serum adenosine deaminase(ADA) and its isoenzymes in serum of patients with autoimmune diseases. Methods: Patients with systemic lupus erythematosus(SLE), rheumatoid arthritis(RA)patients and ankylosing spondylitis(AS) were included in this study. Serum ADA activity were detected in 70 SLE, 114 RA, 55 AS and their sex & age matched healthy controls. A receiver operating characteristic(ROC) curve analysis was applied to evaluate the diagnostic performance of serum ADA activity. Results: Compared with healthy controls, ADA activity was significantly increased in the serum of SLE patients(t ADA activity: 15(12,20) vs 8(7,10) U/L. ADA1 activity: 3.5(2,5) vs 3(2,3) U/L;ADA2 activity: 11(8,15) vs 6(5,7)U/L;P<0.01). Compared with the healthy controls, serum ADA2 activity were increased in RA patients(8(5.25,10) vs 7(5,9) U/L, P<0.05), while there was no significant change in serum t ADA and ADA1 activity in RA patients(P>0.05). And moreover, serum ADA2 activity was increased in AS patients(7(5,9) vs 6(5,7) U/L, P<0.05), while there were no significant change in serum t ADA and ADA1 activity in AS patients(P>0.05). ROC analysis showed that t ADA and ADA2 activity could be used in diagnosing SLE(t ADA: 88.6%specificity, 77.1% sensitivity;ADA2:92.9% specificity, 68.6% sensitivity). Spearman correlation analysis showed that serum t ADA activity was positively correlated with disease activity(SLEDAI) in SLE patients(r=0.303, P=0.011). Conclusion: Serum t ADA activity can be used as a potential diagnostic and monitoring marker for SLE patients.