膝骨关节炎患者血清脂氧素A4、富含半胱氨酸蛋白61水平及其与病情严重程度的相关性

Serum levels of lipoxin A4 and cysteine-rich protein 61 in patients with knee osteoarthritis and their correlation with disease severity

目的探讨膝骨关节炎患者血清脂氧素A4、富含半胱氨酸蛋白61水平及其与病情严重程度的相关性。方法回顾性选取2017年10月至2019年10月在咸宁市中心医院(湖北科技学院附属第一医院)治疗的106例膝骨关节炎患者作为研究对象,并根据Kellgren-Lawrence(K-L)分级标准将患者分为轻中度组(63例)和重度组(43例),另选取同期体检健康者80例为对照组。通过酶联免疫吸附法检测所有受检者的血清LXA4和Cyr61水平;采用Spearman相关性检验分析膝骨关节炎患者血清LXA4和Cyr61水平与病情严重程度的相关性;采用Logistic回归分析膝骨关节炎患者病情严重程度的影响因素;采用受试者工作特征(ROC)曲线分析血清LXA4和Cyr61联合检测对膝骨关节炎患者病情严重程度的预测效能。结果重度组和轻中度组血清LXA4水平低于对照组[(39.57±6.20)、(46.16±7.77)μg/L比(56.47±9.62)μg/L],重度组血清LXA4水平低于轻中度组,差异均有统计学意义(P<0.05)。重度组和轻中度组血清Cyr61水平高于对照组[(96.88±8.47)、(89.76±10.47)ng/L比(25.07±2.77)ng/L],重度组血清Cyr61水平高于轻中度组,差异均有统计学意义(P<0.05)。Spearman相关性检验结果显示,膝骨关节炎患者病情严重程度与血清LXA4水平呈负相关性(r=-0.451,P<0.05),与血清Cyr61水平呈正相关性(r=0.358,P<0.05)。Logistic回归分析结果显示,血清Cyr61、LXA4水平是膝骨关节炎患者病情严重程度的影响因素(P<0.05);ROC曲线分析结果显示,血清LXA4和Cyr61水平联合检测预测重度膝骨关节炎患者的曲线下面积(AUC)为0.819,灵敏度为79.07%,特异度为79.34%。结论膝骨关节炎患者血清LXA4水平降低,Cyr61水平升高,并与患者病情严重程度有关,二者联合检测能够较好地辅助诊断膝骨关节炎严重程度。

Objective To explore the correlation between the levels of serum lipoxin A4(LXA4),cysteine-rich protein 61(Cyr61)and disease severity in patients with knee osteoarthritis.Methods A total of 106 patients with knee osteoarthritis treated in the Xianning Central Hospital(the First Affiliated Hospital of Hubei University of Science and Technology)from October 2017 to October 2019 were selected as the study subjects,and the patients were divided into mild to moderate group(63 cases)and severe group(43 cases)according to the Kellgren-Lawrence(K-L)grading criteria.Meanwhile 80 healthy subjects who underwent physical examination during the same period were selected as the control group.The levels of serum LXA4 and Cyr61 were detected by enzyme-linked immunosorbent assay.Spearman correlation was used to analyze the correlation between serum LXA4 and Cyr61 levels and the severity of knee osteoarthritis.Logistic regression was used to analyze the influencing factors of the severity of knee osteoarthritis.Receiver operative characteristic(ROC)curve was used to analyze the predictive efficacy of serum LXA4 and Cyr61 in patients with severe knee osteoarthritis.Results The serum LXA4 level in the control group was(56.47±9.62)μg/L,which was significantly higher than that in the mild to moderate group(46.16±7.77)μg/L and the severe group(39.57±6.20)μg/L,and the serum LXA4 level in the mild to moderate group was higher than that in the severe group,there were statistical differences(P<0.05).The serum Cyr61 level in the control group was(25.07±2.77)ng/L,which was significantly lower than that in the mild to moderate group(89.76±10.47)ng/L and the severe group(96.88±8.47)ng/L,and the serum LXA4 level in the mild to moderate group was lower than that in the severe group,there were statistical differences(P<0.05).Spearman correlation analysis showed that the severity of disease in patients with knee osteoarthritis was negatively correlated with serum LXA4 level(r=-0.451,P<0.05)and positively correlated with serum Cyr61 level(r=0.358,P<0.05).The results of Logistic regression analysis showed that serum Cyr61 and LXA4 were predictors of the severity of knee osteoarthritis(P<0.05).The area under the curve(AUC)of combination of serum LXA4 and Cyr61 in predicting severe knee osteoarthritis was 0.819,the sensitivity was 79.07%,and the specificity was 79.34%.Conclusions The decrease of serum LXA4 level and the increase of Cyr61 level in patients with knee osteoarthritis are related to the severity of the disease.The combination of the two has the ability of clinical auxiliary diagnosis of the severity of osteoarthritis.