[1]邓正鑫a,刘惠杰b,冯长州a,等.原发性舍格伦综合征患者血清MPO-DNA 水平与疾病活动度的相关性研究[J].现代检验医学杂志,2024,39(05):102-106.[doi:10.3969/j.issn.1671-7414.2024.05.019]
　DENG Zhengxina,LIU huijieb,FENG Changzhoua,et al.Study on the Correlation between Serum MPO-DNA Levels and Disease Activity in Patients with Primary Sj?gren’s Syndrome[J].Journal of Modern Laboratory Medicine,2024,39(05):102-106.[doi:10.3969/j.issn.1671-7414.2024.05.019]
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原发性舍格伦综合征患者血清MPO-DNA 水平与疾病活动度的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年05期
页码:
102-106
栏目:
论著
出版日期:
2024-09-15

文章信息/Info

Title:
Study on the Correlation between Serum MPO-DNA Levels and Disease Activity in Patients with Primary Sj?gren’s Syndrome
文章编号:
1671-7414（2024）05-102-05
作者:
邓正鑫a; 刘惠杰b; 冯长州a; 周 颖a; 张欢欢a; 杨 晋a
（徐州医科大学附属连云港医院a.检验科；b. 风湿免疫科，江苏连云港 222000）
Author(s):
DENG Zhengxina;  LIU huijieb;  FENG Changzhoua;  ZHOU Yinga;  ZHANG Huanhuana;  YANG Jina
（a. Department of Clinical Laboratory；b. Rheumatology and Immunology, the Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu Lianyungang 222000, China）
关键词:
中性粒细胞体外诱捕网; 原发性舍格伦综合征; 疾病活动度
分类号:
R593.2；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.05.019
文献标志码:
A
摘要:
目的 研究中性粒细胞胞外诱捕网(neutrophil extracellular traps，NETs) 在不同疾病活动度的原发性舍格伦综合征（primary Sj?gren’s syndrome，pSS）患者外周血中的表达及意义，探究NETs 及常规检验指标抗凝血酶（antithrombin III，AT III）、碱性磷酸酶（alkaline phosphatase，ALP）、糖类抗原125（carbohydrate antigen 125，CA125）对pSS 疾病活动度的预测价值。方法 选取2021 年10 月～2023 年12 月徐州医科大学附属连云港医院收治的94 例pSS 初诊患者，根据欧洲风湿病联盟（European League Against Rheumatism，EULAR）干燥综合征疾病活动指数（ Sj?gren’s syndrome disease activity index，ESSDAI）分为活动期组（n=49）和非活动期组（n=45）。采用酶联免疫吸附法（ELISA）检测NETs 生物标志物即血清髓过氧化物酶（myeloperoxidase，MPO）-DNA复合物水平；将实验室常规指标和MPO-DNA纳入多因素Logistic回归筛选出pSS 疾病活动度独立影响因素；Pearson 法分析MPO-DNA与ESSDAI 评分的相关性；受试者工作特征（ROC）曲线评估MPO-DNA单独或联合AT III，ALP，CA125 对pSS 疾病活动度的预测价值。结果 pSS活动期组患者血清MPO-DNA（23.884±3.494 μg/L），ALP（80.159±34.318 U/L），CA125（20.300±16.560 U/ml）水平显著高于非活动期（19.024±3.324 μg/L，67.500±21.166 U/L，13.200±6.340 U/ml），AT III 活动期（89.180±15.040 ng/ml）低于非活动期（94.650±11.620 ng/ml），差异具有统计学意义（t=-7.921，-2.426，-2.925，2.094，均P＜ 0.05）。多因素Logistic回归分析发现，MPO-DNA，ALP，CA125为pSS疾病活动度独立危险因素，AT III为独立保护因素（均P＜ 0.05）；MPO-DNA与ESSDAI评分呈正相关关系（r=0.602，P＜ 0.01）。ALP，CA125，AT III联合预测pSS疾病活动度曲线下面积（95%置信区间）[AUC（95%CI）] 为0.711（0.612～0.810），MPO-DNA单独预测AUC（95%CI）为0.837（0.758～0.915），截断值19.869μg/L，MPO-DNA联合ALP，CA125，AT III预测AUC（95%CI）为0.866（0.797～0.935），预测价值得到显著提升。结论 NETs 参与pSS的疾病发生，表达水平与其疾病活动度有关，NETs联合ALP，CA125，AT Ⅲ对于pSS的疾病活动度具备有效的诊断性能，该工具可作为预测pSS疾病活动度的生物指标。
Abstract:
Objective To explore the expression and significance of neutrophil extracellular traps (NETs) in peripheral blood of primary Sj?gren’s syndrome (pSS) patients across different disease activity levels, and the predictive value of NETs and routine laboratory markers antithrombin III (AT III)，alkaline phosphatase (ALP) and carbohydrate antigen 125 (CA125) for pSS disease activity. Methods A total of 94 newly diagnosed pSS patients at the Affiliated Lianyungang Hospital of Xuzhou Medical University from October 2021 to December 2023 were categorized into active (n=49) and non-active (n=45) groups based on the European League Against Rheumatism(EULAR) Sj?gren’s Syndrome disease activity index (ESSDAI). The levels of NETs biomarkers, namely serum myeloperoxidase（MPO）-DNA, were measured using ELISA. Laboratory routine indicators and MPODNA were integrated into multivariate Logistic regression to screen for independent influencing factors of pSS disease activity. Pearson’s correlation was used to evaluate the relationship between MPO-DNA levels and ESSDAI scores. The efficacy of MPO-DNA alone or in combination with AT III, ALP and CA125, for predictors of disease activity was evaluated using ROC curve. Results Serum MPO-DNA (23.884±3.494 μg/L), ALP (80.159±34.318 U/L) and CA125 (20.300±16.560 U/ml) levels of active pSS patients were higher than those in the non-active patients (19.024±3.324μg/L, 67.500±21.166U/L, 13.200±6.340 U/ml), while AT III (89.180±15.040 ng/ml) was lower than that in non-active patients (94.650±11.620 ng/ml), with significant differences (t= -7.921，-2.426，-2.925，2.094，all P<0.05). Multivariate Logistic regression analysis showed laboratory indicator MPO-DNA, ALP and CA125 were independent risk factors, while AT III was an independent protective factor (all P<0.05). MPO-DNA was positively correlated with ESSDAI scores (r=0.602, P<0.01). The AUC (95%CI) of the combination of ALP，CA125 and AT III for predicting disease activity in pSS was 0.711(0.612～0.810). The AUC(95%CI) of MPO-DNA alone for predicting disease activity in pSS was 0.837 (0.758～0.915), and the AUC(95%CI) of combination of MPO-DNA, ALP, CA125 and AT III for predicting disease activity in pSS was 0.866 (0.797～0.935), showing an improving in the predictive value. Conclusion The involvement of NETs in the occurrence and expression levels of pSS is related to its disease activity. NETs combined with ALP, CA125 and AT III have effective diagnostic performance for the disease activity of pSS. This tool can serve as a biological indicator for predicting the disease activity of pSS.

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备注/Memo

备注/Memo:
基金项目：连云港市卫生科技项目（面上课题）（编号：202313）。
作者简介：邓正鑫（1998-），男，硕士，住院医师，研究方向：临床检验诊断学，E-mail：Dengzhengxin037@163.com。
通讯作者：杨晋（1975-），男，硕士，主任技师，研究方向：临床免疫学检验，E-mail：YangjinLyg@163.com。
更新日期/Last Update: 2024-09-15