外周血血管内皮生长因子和可溶性致癌抑制因子2及程序性死亡受体1与类风湿关节炎患者疾病活动度的相关性

Correlations of serum vascular endothelial growth factor,soluble suppression of tumorigenicity-2 and programmed death receptor-1 in peripheral blood with disease activity of RA patients

目的观察类风湿关节炎(RA)患者外周血血管内皮生长因子(VEGF)、可溶性致癌抑制因子2(sST2)、程序性死亡受体1(PD-1)水平变化,探讨其与疾病活动度的相关性。方法2021年3月—2023年2月商丘市第一人民医院诊治RA患者140例为RA组,同期健康体检者140例为对照组。RA组入院次日、对照组体检日检测血清VEGF、sST2及血浆PD-1水平。采用28个关节疾病活动度评分(DAS28)评估RA患者疾病活动度,140例RA患者根据DAS28评分分为缓解期组(DAS28评分≤2.6分)33例、低活动度组(DAS28评分>2.6~3.2分)27例、中活动度组(DAS28评分>3.2~5.1分)39例和高活动度组(DAS28评分>5.1分)41例。比较RA组与对照组、不同疾病活动度RA患者外周血VEGF、sST2、PD-1水平;采用Spearman相关法分析RA患者疾病活动度与外周血VEGF、sST2、PD-1水平的相关性。结果RA组外周血VEGF、sST2、PD-1水平[(86.74±23.15)ng/L、(48.75±8.92)μg/L、(32.51±6.57)μg/L]均高于对照组[(38.61±11.20)ng/L、(11.23±4.17)μg/L、(14.82±3.11)μg/L](t=22.144、45.086、28.795,P均<0.05)。低活动度组、中活动度组、高活动度组外周血VEGF[(69.92±18.65)、(86.70±20.33)、(133.95±31.48)ng/L]、sST2[(33.59±8.51)、(44.84±15.52)、(82.31±22.78)μg/L]、PD-1[(24.35±4.79)、(30.10±5.73)、(50.07±7.86)μg/L]水平均高于缓解期组[(41.89±15.47)ng/L、(21.63±7.22)μg/L、(20.22±4.52)μg/L](P<0.05);低活动度组、中活动度组、高活动度组外周血VEGF、sST2、PD-1水平均依次升高(P<0.05)。RA患者疾病活动度与外周血VEGF、sST2、PD-1水平均呈正相关(r=0.526,P<0.001;r=0.559,P<0.001;r=0.846,P<0.001)。结论RA患者外周血VEGF、sST2、PD-1水平升高,且疾病活动度越高,外周血VEGF、sST2、PD-1水平越高。

Objective To observe the changes of vascular endothelial growth factor(VEGF),soluble suppression of tumorigenicity-2(sST2)and programmed death receptor-1(PD-1)in peripheral blood of patients with rheumatoid arthritis(RA),and to investigate their correlations with the disease activity.Methods Totally 140 patients with RA(RA group)were diagnosed and treated in the First People's Hospital of Shangqiu from March 2021 to February 2023,and another 140 healthy volunteers received physical examination during the same period(control group).The serum levels of VEGF and sST2 as well as the plasma level of PD-1 were detected on the next day of admission in RA group and on the physical examination day in control group.The disease activity score in 28 joints(DAS28)was used to evaluate the disease activity of RA,by which 140 RA patients were divided into 33 patients with DAS28≤2.6(remission group),27 patients with DAS28>2.6-3.2(low-activity group),39 patients with DAS28>3.2-5.1(medium-activity group)and 41 patients with DAS28>5.1(high-activity group).The levels of VEGF,sST2 and PD-1 were compared between RA group and control group and among different disease activity groups.The correlations of the disease activity with the levels of VEGF,sST2 and PD-1 in RA patients were analyzed by Spearman correlation analysis.Results The levels of VEGF,sST2 and PD-1 were higher in RA group[(86.74±23.15)ng/L,(48.75±8.92)μg/L,(32.51±6.57)μg/L]than those in control group[(38.61±11.20)ng/L,(11.23±4.17)μg/L,(14.82±3.11)μg/L](t=22.144,45.086,28.795;all P values<0.05),were higher in low-activity group[(69.92±18.65)ng/L,(33.59±8.51)μg/L,(24.35±4.79)μg/L],medium-activity group[(86.70±20.33)ng/L,(44.84±15.52)μg/L,(30.10±5.73)μg/L]and high-activity group[(133.95±31.48)ng/L,(82.31±22.78)μg/L,(50.07±7.86)μg/L]than those in remission group[(41.89±15.47)ng/L,(21.63±7.22)μg/L,(20.22±4.52)μg/L](P<0.05),and increased sequentially in low-,medium-and high-activity groups(P<0.05).The disease activity of RA patients was positively correlated with VEGF,sST2,and PD-1 levels(r=0.526,P<0.001;r=0.559,P<0.001;r=0.846,P<0.001).Conclusion The levels of serum VEGF,sST2 and PD-1 increase in the peripheral blood of RA patients,and increase with the elevation of the disease activity.