摘要
目的观察膝骨性关节炎(KOA)患者血清葡萄糖-6-磷酸异构酶(GPI)、抗突变型瓜氨酸波形蛋白(MCV)抗体水平变化,并探讨其意义。方法 100例KOA患者按照病情进展分为早期组、中晚期组各50例,另选50例健康体检者作为对照组,比较各组GPI、抗MCV抗体、血沉(ESR)、C反应蛋白(CRP)水平,并分析各指标的相关性。结果早期组血清GPI、抗MCV抗体、ESR、CRP水平分别为(0. 038±0. 110) mg/L、(11. 40±15. 05) U/mL、(19. 08±20. 70) mm/h、(10. 10±23. 60) mg/L;中晚期组分别为(0. 098±0. 560) mg/L、(7. 13±8. 67) U/mL、(21. 30±21. 87) mm/h、(24. 35±34. 90) mg/L;对照组分别为(0. 010±0. 050) mg/L、(4. 80±2. 87) U/mL、(10. 77±5. 65)mm/h、(1. 17±1. 03) mg/L;早期组、中晚期组各指标分别与对照组比较,早期组CRP水平与中晚期组比较,P均<0. 05。KOA患者血清GPI水平与CRP水平呈正相关(r=0. 27,P <0. 05),与ESR水平无相关性(r=0. 06,P>0. 05);抗MCV抗体水平与CRP、ESR水平无相关性(r=0. 03、0. 14,P均> 0. 05)。结论 KOA患者血清中GPI、抗MCV抗体水平升高,检测两指标有助于KOA的诊断及病情评估。
Objective To observe the changes of glucose-6-phosphate isomerase( GPI) and anti-mutated citrullinated vimentin( MCV) antibody in serum of patients with knee osteoarthritis( KOA) and to explore its significance. Methods According to the disease progression,100 patients with KOA were divided into the early stage group and the middle and late stage group with 50 cases in each,and the healthy examiners were selected as the control group. The levels of GPI,anti-MCV antibody,erythrocyte sedimentation rate( ESR),and C-reactive protein( CRP) in each group were compared,and the correlation of each index was analyzed. Results The levels of GPI,anti-MCV antibody,ESR,and CRP levels in serum were( 0. 038 ± 0. 11) mg/L,( 11. 4 ± 15. 05) U/mL,( 19. 08 ± 20. 7) mm/h,( 10. 1 ± 23. 6) mg/l,respectively in the early group,( 0. 098 ± 0. 56) mg/L,( 7. 13 ± 8. 67) U/mL,( 21. 3 ± 21. 87) mm/h,and( 24. 35 ± 34. 9) mg/L,respectively,in the middle and late group,and( 0. 01 ± 0. 05) mg/L,( 4. 8 ± 2. 87) U/mL,( 10. 77 ± 5. 65) mm/h,and( 1. 17 ± 1. 03) mg/L,respectively,in the control group. Significant difference was found in each index between the early stage group and middle and late stage group,as well as in the CRP level between the early stage group and the middle and late stage group( all P < 0. 05). The serum GPI level was positively correlated with CRP level in KOA patients( r = 0. 27,P < 0. 05),but was not with ESR level( r = 0. 06,P > 0. 05). There was no correlation between anti-MCV antibody level and CRP and ESR levels( r = 0. 03 and 0. 14,all P > 0. 05) Conclusion The levels of GPI and anti-MCV antibody in serum of KOA patients increase,and the detection of two indexes is helpful to the diagnosis and evaluation of KOA.
引文
[1]Liu Q,Niu J,Huang J,et al.Knee osteoarthritis and all-cause mortality:the Wuchuan Osteoarthritis Study[J].Osteoarthritis Cartilage,2015,23(7):1154-1157.
[2]陈则亦,康翼,付维力.骨关节炎相关生物标志物[J].中国生物化学与分子生物学报,2018,34(11):1175-1184.
[3]Scanzello CR.Role of low-grade inflammation in osteoarthritis[J].Curr Opin Rheumatol,2017,29(1):79-85.
[4]Zhang J.Meta-analysis of serum C-reactive protein and cartilage oligomeric matrix protein levels as biomarkers for clinical knee osteoarthritis[J].BMC Musculoskelet Disord,2018,19(1):22-28.
[5]Damen J,van Rijn RM,Emans PJ,et al.Prevalence and development of hip and knee osteoarthritis according to American College of Rheumatology criteria in the CHECK cohort[J].Arthritis Res Ther,2019,21(1):4-10.
[6]徐婧,刘婧,朱雷,等.葡萄糖-6-磷酸异构酶水平测定与类风湿关节炎早期诊断[J].北京大学学报(医学版),2016,48(6):942-946.
[7]Zong M,Lu T,Fan S,et al.Glucose-6-phosphate isomerase promotes the proliferation and inhibits the apoptosis in fibroblast-like synoviocytes in rheumatoid arthritis[J].Arthritis Res Ther,2015,17:100-111.
[8]van Heemst J,Trouw LA,Nogueira L,et al.An investigation of the added value of an ACPA multiplex assay in an early rheumatoid arthritis setting[J].Arthritis Res Ther,2015,17:276-285.
[9]Recht MP,Kramer J,Marcelis S,et al.Abnormalities of articular cartilage in the knee:analysis of available MR techniques[J].Radiology,1993,187(2):473-478.
[10]Outerbridge RE.Further studies on the etiology of chondromalacia patellae[J].J Bone Joint Surg Br,1964,46:179-190.
[11]Hinks TS,Brown T,Lau LC,et al.Multidimensional endotyping in patients with severe asthma reveals inflammatory heterogeneity in matrix metalloproteinases and chitinase 3-like protein 1[J].J Allergy Clin Immunol,2016,138(1):61-75.
[12]Rempe RG,Hartz AMS,Bauer B.Matrix metalloproteinases in the brain and blood-brain barrier:versatile breakers and makers[J].JCereb Blood Flow Metab,2016,36(9):1481-507.
[13]Gait AD,Hodgson R,Parkes MJ,et al.Synovial volume vs synovial measurements from dynamic contrast enhanced MRI as measures of response in osteoarthritis[J].Osteoarthritis Cartilage,2016,24(8):1392-1398.
[14]李得春.老年骨性关节炎患者血液和关节液炎症因子与疾病活动的关系[J].中国实验诊断学,2014,8:1339-1340.
[15]肖勇,孙建宇,罗祯敏.补肾健骨胶囊对类风湿关节炎患者RF、hs-CRP、ESR的影响[J].中国生化药物杂志,2017,37(1):119-122.
[16]罗坚,王祥华.全膝关节置换联合云南白药治疗膝关节骨性关节炎的疗效及对ESR、血清CRP、MMP-9水平的影响[J].中国老年学杂志,2017,37(9):2247-2248.
[17]Luyten FP,Bierma-Zeinstra S,Dell'Accio F,et al.Toward classification criteria for early osteoarthritis of the knee[J].Semin Arthritis Rheum,2018,47(4):457-463.
[18]沈宝岩,黄建军.类风湿关节炎患者血清GPI检测及其诊断价值的研究[J].国际检验医学杂志,2014,35(4):396-398.
[19]张恩水,闫新峰,张明,等.聚蛋白多糖酶和基质金属蛋白酶在骨关节炎不同时期关节液中的表达[J].山东大学学报(医学版),2012,50(7):87-91.
[20]郑洁,袁普卫.骨性关节炎的代谢机制研究进展[J].中国骨质疏松杂志,2018,24(3):406-410.
[21]Kawaguchi H,Matsumoto I,Osada A,et al.Identification of novel biomarker as citrullinated inter-alpha-trypsin inhibitor heavy chain4,specifically increased in sera with experimental and rheumatoid arthritis[J].Arthritis Res Ther,2018,20(1):66-78.
[22]刘轩,王静,赵静,等.抗MCV抗体对抗CCP抗体阴性类风湿关节炎的诊断价值[J].徐州医学院学报,2016,36(11):740-742.