类风湿关节炎患者血清生长停滞特异性蛋白6表达水平与疾病活动度的相关性研究

Correlation between Growth Arrest-Specific Protein 6 Expression and Disease Activity in Patients with Rheumatoid Arthritis

目的探讨血清生长停滞特异性蛋白6(growth arrest-specific protein 6,Gas6)在类风湿关节炎(rheumatoid arthritis,RA)不同活动状态的水平及临床意义。方法该研究采用回顾性分析,收集2020年4月~2021年4月西安医学院第一附属医院确诊为RA的患者102例,收集同期健康体检者98例。对RA患者和健康对照组的血清类风湿因子(rheumatoid factor,RF)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)、抗CCP抗体、补体C1q和Gas6水平进行检测。分析各组结果差异及血清Gas6对RA的诊断效能。结果RA组的血清Gas6表达水平[26.8(21.6,35.3)ng/ml]明显高于健康对照组[20.9(17.0,25.2)ng/ml],差异有统计学意义(Z=-6.03,P<0.01)。重度活动期组Gas6表达水平高于稳定期组和轻度、中度活动期组(Z=-4.82,-4.02,-2.06,均P<0.05),同时中度活动期组显著高于稳定期组(Z=-3.14,P<0.05),差异均有统计学意义。血清Gas6水平在不同关节侵蚀程度分期患者间差异有统计学意义(H=12.75,P<0.05)。血清Gas6与RF,ESR,CRP和抗CCP抗体呈正相关(r=0.250~0.401,均P<0.05)。血清Gas6单独检测对RA的诊断特异度最高(92.7%),但敏感度较低(53.4%),曲线下面积(AUC)为0.808,六项联合检测时曲线下面积(AUC)为0.979,敏感度和特异度分别为96.8%和97.9%,具有较好的诊断价值。结论RA患者血清Gas6水平显著升高,与RA疾病活动度高度相关。

Objective To investigate the levels and the clinical significance of growth arrest-specific protein 6(Gas6)in different activities of rheumatoid arthritis(RA).Methods By using retrospective study to collect 102 patients with RA diagnosed in the First Affiliated Hospital of Xi’an Medical University from April 2020 to April 2021 as the RA group.During the same time,98 healthy people were selected as the control group.The levels of serum rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),antibady against cyclocitrulline polypeptide,complement C1q and Gas6 were detected in RA patients and healthy controls,and analyzed the difference and diagnostic efficacy of Gas6 in RA.Results The serum Gas6 in the RA group[26.8(21.6,35.3)ng/ml]was significantly higher than that in the healthy control group[20.9(17.0,25.2)ng/ml],the difference was statistically significant(Z=-6.03,P<0.01).The level of Gas6 in the severely active group was higher than that in the stable group,the mildly active group and the moderately active group(Z=-4.82,-4.02,-2.06,all P<0.05),and Gas6 in the moderately active group was significantly higher than that in the stable group(Z=-3.14,P<0.05),the differences were statistically significant,respectively.Gas6 levels showed statistical differences in different stages of joint erosion(H=12.75,P<0.05).Gas6 was positively correlated with RF,ESR,CRP and antibady against cyclocitrulline polypeptide(r=0.250~0.401,all P<0.05).Gas6 alone had the highest diagnostic specificity(92.7%)for RA,but the sensitivity was low(53.4%),and the area under the curve(AUC)was 0.808.The area under the curve(AUC)of the six items combined detection was 0.979,and the sensitivity and specificity were 96.8%and 97.9%,showing good diagnostic value.Conclusion The level of serum Gas6 in the RA group had significantly increased.Gas6 and the disease activity were highly correlated.