类风湿关节炎患者血清14-3-3η蛋白水平及临床检测价值的初步研究

目的:定量测定类风湿关节炎（RA）患者血清14-3-3η蛋白表达水平并探讨其临床检测价值。方法:收集2020年5月—2020年12月在天津中医药大学第一附属医院就诊的136例RA患者（RA组）、65例非RA关节病变患者（疾病对照组）及同期36名健康体检者（健康对照组）作为研究对象，采用光激化学发光法检测所有研究对象的血清14-3-3η水平，酶联免疫法检测抗环瓜氨酸肽抗体（anti-CCP）水平，免疫比浊法检测D-二聚体（D-Dimer）水平，散射比浊法检测类风湿因子（RF）、C反应蛋白（CRP）水平，分析以上指标在不同组间的表达差异以及指标间的相关性。结果:根据14-3-3η水平将RA组分为14-3-3η阳性组与14-3-3η阴性组，阳性组66例，阴性组70例。RA组血清14-3-3η水平显著高于疾病对照组、健康对照组（U=40.5、0.0，均P<0.000 1）；14-3-3η阳性组14-3-3η蛋白与DAS28-CRP评分（DAS28-CRP）、RF呈正相关（r=0.259 8，P＜0.05；r=0.248 0，P＜0.05）；与红细胞沉降率（ESR）、D-Dimer呈负相关（r=-0.235 4，P＜0.05；r=-0.253 6，P＜0.05.）；14-3-3η阳性组RF与anti-CCP的表达均显著高于14-3-3η阴性组（U=758，P=0.000；U=528，P=0.006）。结论:血清14-3-3η蛋白在部分RA患者血清中呈高浓度，且与RF水平以及临床疾病活动度密切相关。

Preliminary study on serum 14-3-3η protein level and clinical detection value in patients with rheumatoid arthritis

Objective: To quantify the concentration of serum 14-3-3η protein in patients with rheumatoid arthritis（RA） and to explore its clinical value. Methods: A total of 136 cases of RA patients（RA group），65 cases of non-RA joint disease patients（disease control group) and 36 cases of healthy individuals（healthy control group） in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from May 2020 to December 2020 were collected. The serum 14-3-3η levels of all subjects were detected by the light-induced chemiluminescence method.The anti-CCP levels were detected by the enzyme-linked immunosorbent method，the D-Dimer levels were detected by the immunoturbidimetric method， and the levels of RF and CRP were detected by the scattering turbidimetric method.Furthermore， the expression differences among three groups and the correlations of those biomarkers mentioned above were analyzed. Results: The RA group was divided into 14-3-3η positive group and 14-3-3η negative group according to the serum level of 14-3-3η， with 66 cases in the positive group and 70 cases in the negative group.The serum 14-3-3η level in RA group was significantly higher than that of disease control group and healthy control group（U=40.5， U=0.0，all P＜0.000 1）.The serum 14-3-3η level in14-3-3η positive group was positively correlated with DAS28-CRP and rheumatoid factor（RF）（r=0.259 8，0.248 0， all P＜0.05）and negatively correlated with ESR，D-Dimer（r=-0.235 4，-0.253 6，all P＜0.05）. The expression of both RF and anti-CCP were significantly higher in the 14-3-3 η positive group than those in 14-3-3η negative group（U=758，P=0.000；U=528，P=0.006，respectively）. Conclusion: Serum 14-3-3η protein concentration is highly concentrated in serum of some patients with RA， and is closely related to RF level and clinical disease activity.