强直性脊柱炎患者血清Dickkopf-1蛋白水平分析

目的:分析强直性脊柱炎(AS)患者血清Dickkopf-1蛋白(DKK-1)水平变化并探讨其临床应用价值。方法:选取2016-12—2018-06我院诊治的50名AS患者[AS组,其中21例患者使用肿瘤坏死因子-α(TNF-α)抑制剂治疗(使用TNF-α抑制剂治疗组),29例患者未使用TNF-α抑制剂治疗(未使用TNF-α抑制剂治疗组)],另选取同期50名健康体检者为健康对照(对照组)。检测两组患者血清DKK-1、红细胞沉降率(ESR)和C-反应蛋白(CRP)水平。比较AS组患者治疗前后疾病活动度BASDAI、DKK-1、ESR及CRP水平变化。同时分析AS患者DKK-1与BASDAI、ESR及CRP的相关性。结果:AS组患者血清DKK-1水平明显低于对照组(P<0.01)。治疗6个月后,AS患者各亚组BASDAI、ESR及CRP水平较治疗前明显下降(P<0.01),且使用TNF-α抑制剂治疗组较未使用TNF-α抑制剂治疗组下降更明显(P<0.01);两组DKK-1水平与治疗前差异均无统计学意义(P>0.05)。AS患者各亚组血清DKK-1与BASDAI、ESR和CRP水平均无明显相关性。结论:DKK-1可能参与AS的新骨形成。TNF-α抑制剂可能对AS新骨形成无阻止作用。

Analysis of the Serum Dickkopf-1 Levels in Patients with Ankylosing Spondylitis

Objective:To analyse the serum Dickkopf-1(DKK-1)level and to investigate its clinical significance in patients with ankylosing spondylitis(AS).Method:50 patients with AS who were admitted and treated in our hospital from December 2016 to June 2018 were divided into AS group,including 21 patients treated with TNF-αantagonist group,and 29 patients treated without TNF-αantagonist group,and 50 healthy subjects were selected as the healthy control.The blood specimens were collected in patients of both groups,then the levels of DKK-l,erythrocyte sedimentation rat(ESR)and C reactive protein(CRP)in peripheral blood of patients were detected.Compareed the levels of DKK-l,ESR,CRP and BASDAI of the patients with AS group,at baseline and after 6 months of treatment.The relationship between DKK-1 and BASDAI,ESR and CRP of the patients with AS group was analysed.Results:The serum level of DKK-1 in the AS group was significantly lower than that of the control group(P<0.01).After 6 months of treatment,BASDI,ESR and CRP level of the AS group significantly decreased than those of at the baseline(P<0.01),moreover,BASDI,ESR and CRP level of the AS patients treated with TNF-αantagonist significantly decreased than of the AS patients treated without TNF-αantagonist(P<0.01).But the serum level of DKK-1 was no statistically significant difference at baseline and after 6 months of treatment(P>0.05).There was no significant correlation between the serum level of DKK-1 and ESR,CRP,and BASDAI in the AS groups Conclusion:DKK-1 may be involved in ankylosing spondylitis ossification.TNF-αantagonist may have no obvious preventive effect on the ossification process.