类风湿关节炎患者血清Hsa_circ_0083964的表达及其临床价值

Expression and clinical value of serum Hsa_circ_0083964 in patients with rheumatoid arthritis

目的探讨类风湿关节炎(rheumatoid arthritis,RA)患者血清Hsa_circ_0083964的表达及其临床价值。方法收集2021年1月—2023年3月儋州市人民医院肾内科收治的RA患者临床资料,根据28个关节疾病活动性评分(28 disease activity scores,DAS28)将RA患者分为低活动组48例(DAS28评分≤3.2),中度活动组33例(3.2<DAS28评分≤5.1),高活动组28例(DAS28评分>5.1),随机选取50例体检正常者作为对照组。比较各组血清Hsa_circ_0083964、类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸肽(cyclic citrullinated peptide,CCP)抗体水平。应用ROC曲线分析Hsa_circ_0083964联合RF及抗CCP抗体对RA的诊断价值。结果RA组血清Hsa_circ_0083964(2.64±0.92比0.91±0.14)、RF[(104.72比15.83)IU/mL]及抗CCP抗体[(113.95比2.50)RU/mL]水平明显高于对照组(P<0.001)。109例RA患者的RF阳性率为83.5%(91/109),抗CCP抗体阳性率为76.1%(83/109)。RF和抗CCP抗体阳性组血清Hsa_circ_0083964表达水平明显高于RF和抗CCP抗体阴性组(P<0.001)。RA患者疾病活动度越高,血清Hsa_circ_0083964、RF及抗CCP抗体水平越高,高活动组>中活动组>低活动组(P<0.001)。ROC曲线分析显示,血清Hsa_circ_0083964表达水平≥1.92诊断RA的特异度最高(84.0%),Hsa_circ_0083964联合RF及抗CCP抗体诊断RA的曲线下面积最大(0.908,95%CI:0.845~0.971),其准确度为91.4%。相关分析显示,RA患者血清Hsa_circ_0083964水平与RF(r=0.821,P<0.001)和抗CCP抗体(r=0.764,P<0.001)均呈正相关。结论血清Hsa_circ_0083964水平在RA患者中明显升高,其高表达与疾病活动度相关,Hsa_circ_0083964联合RF及抗CCP抗体检测有助于提高RA的诊断效能。

Objective To investigate the expression and clinical value of serum Hsa_circ_0083964 in patients with rheumatoid arthritis(RA).Methods A total of 109 patients with RA(RA group)and 50 normal controls(control group)were included.According to 28 joint disease activity scores(DAS28),RA patients were divided into low activity group(48 cases,DAS28 score≤3.2),moderate activity group(33 cases,3.2<DAS28 score≤5.1),and high activity group(28 cases,DAS28 score>5.1).Compare the levels of serum Hsa_circ_0083964,rheumatoid factor(RF),and anti cyclic citrullinated peptide(CCP)antibodies in each group.ROC curve was used to analyze the diagnostic value of Hsa_circ_0083964 combined with RF and anti-CCP antibody in RA,and Spearman correlation was used for correlation analysis.Results The levels of serum Hsa_circ_0083964(2.64±0.92 vs 0.91±0.14),RF(104.72 vs 15.83,IU/mL)and anti-CCP antibody(113.95 vs 2.50,RU/mL)in RA group were significantly higher than those in control group(P<0.001).The positive rate of RF and anti-CCP antibodies in 109 RA patients was 83.5%(91/109)and 76.1%(83/109)respectively.The expression level of Hsa_circ_0083964 in RF and anti-CCP antibody positive group was significantly higher than that in RF and anti-CCP antibody negative group(P<0.001).The higher the activity of RA patients,the higher the serum Hsa_circ_0083964,RF and anti-CCP antibody levels,high activity group>medium activity group>low activity group(P<0.001).ROC curve analysis showed that serum Hsa_circ_0083964 expression level≥1.92 had the highest specificity in the diagnosis of RA(84.0%),and Hsa_circ_0083964 combined with RF and anti-CCP antibody had the largest area under the curve(AUC)in the diagnosis of RA(0.908,95%CI:0.845-0.971),and its accuracy was 91.4%.Correlation analysis showed that serum Hsa_circ_0083964 levels in RA patients were positively correlated with RF(r=0.821,P<0.001)and anti-CCP antibody(r=0.764,P<0.001).Conclusion The serum Hsa_circ_0083964 level is significantly increased in patients with RA,and its high expression is related to disease activity.The Hsa_circ_0083964 combined with RF and anti-CCP antibody detection can improve the diagnostic efficiency of RA.