钙网织蛋白在类风湿关节炎早期诊断及活动度评估中的作用

Role of calreticulin in early diagnosis and activity assessment of rheumatoid arthritis

摘要:

目的探讨钙网织蛋白（CRT）在类风湿关节炎（RA）早期诊断和疾病活动度评估中的作用及临床意义。方法收集45 例早期活动性RA 患者、35 例骨性关节炎（OA）患者，以及30 例正常对照者（HC）的血清标本。采用酶联免疫吸附法检测3 组患者血清CRT 水平，魏氏法检测红细胞沉降率（ESR），免疫散射比浊法检测C 反应蛋白（CRP）的水平。采用Spearman 对血清CRT水平与疾病活动度评分（DAS28）、ESR、CRP进行相关性分析。结果RA 组血清CRT 水平[（6.7±2.5）μg/L]高于OA 组[（3.9±0.9）μg/L]和HC 组[（3.8±0.7）μg/L]（P <0.05），OA 组与HC 组的血清CRT 水平比较，差异无统计学意义（ P>0.05）；与OA 组和HC 组比较，RA 组ESR、CRP 水平升高（P <0.05）；RA 组血清CRT 水平与DAS28 评分、ESR 及CRP 呈正相关（rs =0.391、0.459 和0.454，P =0.008、0.002 和0.002）。结论早期活动性RA 患者血清CRT 水平增高，CRT 与DAS28 评分、ESR 及CRP 呈正相关，提示CRT 可能成为早期诊断RA，以及辅助ESR、CRP 评估RA 疾病活动度的潜在血清学指标。

Abstract:

Objective To investigate the role of calreticulin (CRT) in the diagnosis and assessment of disease activity in the patients with early rheumatoid arthritis (RA). Methods Serum CRT level was measured by ELISA in 45 patients with early RA, 35 cases with osteoarthritis (OA) and 30 healthy controls (HC). ESR was measured by the Westergren method. Serum CRP level was measured by immunonephelometry. The correlations of CRT with Disease Activity Score for 28 joints (DAS28 score), ESR and CRP were assessed by Spearman's rank correlation coefficient. Results The serum concentration of CRT of the early RA patients[(6.7 ±2.5) μg/L] was higher than that of the OA patients and HC [(3.9 ±0.9) and (3.8 ±0.7) μg/L,P < 0.05],while there was no significant difference between the OA and HC groups (P > 0.05). Compared with the OA and HC groups, the ESR and CRP levels were elevated in the early RA group (P < 0.05). Serum CRT concentration in the early RA patients was positively correlated with DAS28 score, ESR and CRP ( rs=0.391,0.459 and 0.454;P = 0.008, 0.002 and 0.002). Conclusions Together with ESR and CRP, CRT may be used as a potential biomarker for early diagnosis of RA and for assessment of disease activity.