血清CYR61、IL-17、Klotho蛋白对Graves眼病病情的评估价值

Evaluation value of serum CYR61,IL⁃17 and Klotho protein in patients with Graves eye disease

目的 探讨血清高半胱氨酸蛋白61(CYR61)、白细胞介素-17(IL-17)、单向跨膜蛋白(Klotho)对Graves眼病(GO)病情的评估价值。方法 收集2020年1月至2023年10月于郑州大学第一附属医院眼五科诊治的103例患者的临床资料为研究对象,根据临床活动性评分(CAS)评估患者病情,将其分为活动期组42例及非活动期组61例,比较两组患者一般资料、临床基础指标[肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及TSH受体抗体(TRAb)、CYR61、IL-17、Klotho蛋白水平及CAS评分],并通过多因素回归分析和ROC曲线分析GO眼病活动期的相关影响因素以及预测价值。结果 活动组Klotho、TSH、FT3、FT4、TRAb、TNF-α、IFN-γ、CYR61水平及CAS评分相较于非活动组更高,差异有统计学意义(t=7.953,4.364,5.232,6.100,4.364,7.344,4.890,6.541,6.995,13.283,P<0.05);经多因素回归分析得出TSH、FT3、FT4、TRAb、TNF-α、IFN-γ、IL-17、Klotho、CYR61合并CAS评分为影响GO眼病活动期的独立危险因素(OR=1.730,1.667,1.689,1.692,1.742,1.791,1.863,1.887,1.828,1.842,P<0.05);CYR61、IL-17、Klotho联合预测GO活动期的预测价值均高于三者单一检测,曲线下面积(AUC)分别为0.943,0.827,0.817,0.866(P<0.05)。结论 血清CYR61、IL-17、Klotho蛋白与GO活动期密切相关,三者联合联合检测对GO病情预测效能较好,评估价值确切。

Objective To evaluate the value of serum homocysteine protein 61(CYR61),interleu-kin-17(IL-17)and unidirectional transmembrane protein(Klotho)in Graves ophthalmopathy(GO).Meth-ods The clinical data of 103 patients treated in Department 5 of Ophthalmology at the First Affiliated Hospital of Zhengzhou University from January 2020 to October 2023 were retrospectively collected as the study sub-jects.The condition of 103 patients was evaluated based on their clinical activity score(CAS),and they were di-vided into the active group(42 cases)and the inactive group(61 cases).The general data and clinical basic indi-cators(tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),thyrotropin(TSH),free triiodothyronine(FT3),free thyroxine(FT4)and TSH)of the two groups were compared.The levels of receptor antibody(TRAb),CYR61,IL-17,Klotho protein and CAS score were analyzed,and the related influencing factors and predictive value of GO eye disease activity were analyzed by multivariate regression analysis and ROC curve.Results Klotho,TSH,FT3,FT4,TRAb,TNF alpha,IFN-gamma,CYR61 levels,and CAS score of the ac-tive group were higher than those of the inactive group,the difference was statistically significant(t=7.953,4.364,5.232,6.100,4.364,7.344,4.890,6.541,6.995,13.283,P<0.05).Multivariate regression analysis showed that TSH,FT3,FT4,TRAb,TNF-α,IFN-γ,IL-17,Klotho,CYR61 combined with CAS score were independent risk factors affecting the active stage of GO eye disease(OR=1.730,1.667,1.689,1.692,1.742,1.791,1.863,1.887,1.828,1.842,P<0.05).The combined predictive value of CYR61,IL-17,and Klotho for GO activity was higher than that of the three individual tests,and the area under the curve(AUC)was 0.943,0.827,0.817 and 0.866,respectively(P<0.05).Conclusion Serum CYR61,IL-17 and Klotho proteins are closely related to the stage of GO activity.The combined detection of the three proteins is effective in predicting GO disease,with an accurate evaluation value.