类风湿关节炎患者血清骨形态发生蛋白-6和白细胞介素-34表达及其与关节超声指标的相关分析

Expression of serum BMP-6 and IL-34 in patients with rheumatoid arthritis and their correlation with ultrasonography

目的探讨类风湿关节炎(RA)患者血清骨形态发生蛋白-6(BMP-6)和血清白细胞介素-34(IL-34)表达及其与关节超声指标检的相关性分析。方法回顾性分析本院2020年1月至2022年1月收治的RA患者120例,将其作为RA组,参照28处关节疾病活动度评估指数(DAS28)将其分为RA活动期组(84例)和RA缓解期组(36例),所有患者均行超声造影(CEUS)检查,同期选取90名健康体检者作为对照组,比较各组受试者血清BMP-6、IL-34水平、CEUS下时间-强度曲线和定量参数值,同时采用Pearson相关性分析RA患者血清BMP-6和IL-34表达及其与各关节超声指标检的相关性。结果RA组的血清BMP-6、IL-34均明显高于对照组,峰值强度(PI)、曲线下面积(AUC)、滑膜面积均大于对照组,达峰时间(TP)短于对照组(P均<0.01);RA活动期组的血清BMP-6、IL-34明显高于RA缓解期组,PI、AUC、滑膜面积均大于RA缓解期组,TP短于RA缓解期组(P均<0.01);Pearson相关性分析显示,RA患者血清BMP-6、IL-34与PI、AUC呈正相关,与TP呈负相关(均P<0.01)。结论RA患者血清BMP-6和IL-34呈明显高表达,其可反映RA的病理过程及病情变化,同时CEUS可准确评估RA关节滑膜炎活动性,为RA病情变化提供影像学证据。

Objective To investigate the expressions of bone morphogenetic protein-6(BMP-6)and interleukin-34(IL-34)in the serum of patients with rheumatoid arthritis(RA)and their correlation with ultrasonography.Methods A retrospective analysis was performed on 120 RA patients admitted to our hospital from January 2020 to January 2022,and they were selected as RA group.The patients were divided into RA active stage group(84 cases)and RA remission stage group(36 cases)according to the DAS28 joint disease activity assessment index(DAS28).All patients underwent contrast-enhanced ultrasound(CEUS)examination,and 90 healthy subjects were selected as control group during the same period.The serum levels of BMP-6 and IL-34,the time-intensity curve under CEUS,and the quantitative parameter values were compared in all groups.Meanwhile,Pearson correlation was used to analyze the expression of serum BMP-6 and IL-34 in RA patients and their correlation with ultrasonic indicators of each joint.Results Serum BMP-6 and IL-34 in RA group were significantly higher than those in control group,peak intensity(PI),area under the curve(AUC)and synovial area were higher than those in control group,and time to peak(TP)was shorter than those in control group(P<0.01).Serum BMP-6 and IL-34 in RA active stage group were significantly higher than that in RA remission stage group,PI,AUC and synovium area were higher than those in RA remission stage group,and TP was shorter than that in RA remission stage group(P<0.01).Pearson correlation analysis showed that serum BMP-6 and IL-34 in RA patients were positively correlated with PI and AUC,and negatively correlated with TP(all P<0.01).Conclusion Serum BMP-6 and IL-34 in RA patients are significantly highly expressed,which can reflect the pathological process and disease changes of RA.Meanwhile,CEUS can accurately evaluate the synovitis activity of RA joint,providing imaging evidence for the disease changes of RA.