ABCG2和BCAS3基因mRNA在痛风性关节炎患者中的表达水平及辅助诊断价值

Expression of ABCG2 and BCAS3 mRNA in patients with primary gouty arthritis and its auxiliary diagnostic value

目的研究原发性痛风性关节炎患者单个核细胞中ABCG2、BCAS3 mRNA表达分析及其作为原发性痛风性关节炎辅助诊断指标的临床应用。方法选取广州中医药大学第三附属医院和广州市海珠区江海街社区卫生服务中心急性期原发性痛风性关节炎患者(急性期组)36例、非急性期原发性痛风性关节炎患者(非急性期组)55例、无症状高尿酸血症(无症状组)50例、正常对照组81例,贝克曼AU5800全自动生化仪测定生化指标,采用Ficoll密度梯度离心法分离外周血单个核细胞(PBMC),RT-PCR检测PBMC中ABCG2、BCAS3 mRNA的表达水平。结果非急性期组的血尿酸(UA)、白细胞(WBC)、C反应蛋白(CRP)、甘油三酯(TG)、低密度脂蛋白(LDL)、空腹血糖(GLU)显著高于正常对照组,WBC、CRP、TG显著高于无症状组;急性期组的UA、WBC、淋巴细胞数、CRP、总胆固醇(TC)、TG、LDL、GLU显著高于正常对照组,WBC、淋巴细胞数、CRP、TG显著高于无症状组,差异均有统计学意义(P<0.05)。非急性期组的ABCG2 mRNA显著低于无症状组、正常对照组;急性期组的ABCG2 mRNA显著低于无症状组,差异有统计学意义(P<0.05)。BCAS3基因在四组之间差异无统计学意义(P>0.05)。ROC曲线分析,ABCG2(AUC=0.793,95%CI:0.729~0.856,P<0.05)比UA(AUC=0.760,95%CI:0.693~0.827,P<0.05)辅助诊断性能优。结论原发性痛风性关节炎患者外周血单个核细胞低表达ABCG2基因水平,ABCG2 mRNA表达量可以作为原发性痛风性关节炎辅助诊断指标。

Objective To study the expression of ABCG2 and BCAS3 mRNA in mononuclear cells of patients with primary gouty arthritis and its clinical application as an auxiliary diagnostic index for primary gouty arthritis.Methods 36 patients with primary gouty arthritis in the acute phase(acute phase group),55 patients with non-acute primary gouty arthritis(nonacute phase group),50 patients with asymptomatic hyperuricemia(asymptomatic group),and 81 cases in the normal control group were selected from the Third Affiliated Hospital of Guangzhou University of Chinese Medicine and Haizhu Qu Jianghai Jie Community Heal Thservice Center.Beckman AU5800 automatic biochemical analyzer was used to measure biochemical indicators;Ficoll density gradient centrifugation was used to separate peripheral blood mononuclear cells(PBMC),and RTPCR was used to detect the expression levels of ABCG2 and BCAS3 mRNA in PBMC.Results The uric acid(UA),white blood cell(WBC),C-reactive protein(CRP),triglycerides(TG),low-density lipoprotein(LDL),and glucose(GLU)in the non-acute phase group were significantly higher than those in the normal control group(P<0.05).The WBC,CRP,and TG in the non-acute phase group were significantly higher than those in the asymptomatic group(P<0.05).The UA,WBC,lymphocyte numbers,CRP,total cholesterol(TC),TG,LDL and GLU in the acute phase group were significantly higher than those in normal control group;the WBC,lymphocyte number,CRP,and TG in acute phase group were significantly higher than those in asymptomatic group(P<0.05).ABCG2 mRNA level in the non-acute phase group was significantly lower than those in the normal control and asymptomatic groups,and ABCG2 mRNA level in the acute phase group was significantly lower than that in the asymptomatic group(P<0.05).There was no significant difference in BCAS3 gene expression levels between the four groups(P>0.05).ROC curve showed that ABCG2(AUC=0.793,95%CI:0.729-0.856,P<0.05)was better than UA(AUC=0.760,95%CI:0.693-0.827,P<0.05)in assisted diagnostic performance.Conclusion Peripheral blood mononuclear cells of patients with primary gouty arthritis had low expression level of ABCG2;ABCG2 mRNA expression level could be used as an auxiliary diagnostic index for primary gouty arthritis in clinical applications.