sB7-H4对类风湿关节炎病情活动指标及关节功能损害的评估

目的分析类风湿关节炎(Rheumatoid arthritis,RA)可溶性B7-H4(sB7-H4)和病情活动指标DAS28(Disease activity score in 28 joints,DAS28)在治疗前后的变化及相关性,探讨sB7-H4对类风湿关节炎功能损害的评估价值。方法92例RA按病情活动分组,病情稳定组13例,低度活动组12例,中度活动组25例,高度活动组42例。67例RA中度、高度活动组按关节功能分级,1级11例、2级22例、3级24例、4级10例。92例类风湿关节炎酶联免疫吸附试验(ELISA)测定sB7-H4,魏氏法测定血沉(Erythrocyte sedimentation rate,ESR),依据血沉和相关数据计算得出DAS28评分。结果92例RA的sB7-H4(μg/L)治疗前后浓度分别为36.58±12.88、20.73±8.35,DAS28评分治疗前后分别为5.03±1.37、2.62±0.61。治疗前92例RA病情稳定组、低度活动组、中度活动组、高度活动组sB7-H4(μg/L)分别为12.26±4.14、20.55±8.83、32.64±11.52、63.50±23.71;DAS28评分分别为1.84±0.49、3.11±0.76、4.54±1.21、7.22±1.58。67例RA关节功能分级1级、2级、3级、4级sB7-H4(μg/L)分别为29.37±10.19、40.73±13.24、52.32±19.83、68.28±24.46;DAS28评分分别为3.98±1.16、5.72±1.30、6.05±1.62、7.83±1.74。sB7-H4与DAS28评分呈正相关(r为0.483,P0.01)。结论sB7-H4在RA血清中高表达,与RA病情活动指标DAS28评分高度相关,sB7-H4可作为类风湿关节炎疾病进展的评价指标。

Value of detection of sB7-H4 in assessment of disease activity index and joint dysfunction in rheumatoid arthritis patients

Objective To analyze the correlation of variations of soluble B7-H4 （sB7-H4） and rheumatoid arthritis （Rheumatoudarthritis,RA）with disease activity index of DAS28 （Disease activity score in 28 joints, DAS28） before and after treatment, assessment of the value of sB7-H4 on the lesion of rheumatoid arthritis. Methods Based on the severity of the disease, the 92 RA cases were divided into stable disease group （ 13 cases）, the low activity group （12 cases）, moderate activity group （25 cases）, highly active group（42 cases）. The eases in moderate and highly active RA group were based upon the joint function of the cases, classified into Grade 1, Grade 2, Grade 3 and Grade 4 comprised of 11, 22, 24 and 10 eases. The concentrations of sB7-H4 was tested by using ELISA and that of erythroeyte sedimentation rate（Erythrocyte sedimentation rate, ESR） was detected by Westergren method, Then results were assessed by caleulating DAS28 score. Results The concentration of sB7-H4 （μg/L） in RA cases before and after treatment were （36.58 ±12.88）, （20.73 ±8.35）, DAS28 score before and after treatment were （5.03 ± 1.37）, （2.62 ± 0.61）. Before treatment the concentrations of sB7-H4 （μg/L） in RA patients of stable condition group, low activity group, moderate group activities, high activity of group were （ 12.26 ± 4.14）, （20.55 ± 8.83）, （32.64 ± 11.52）, （63.50 ± 23.71）; DAS28 score were （1.84 ± 0.49）,（ 3.11 ± 0.76）, （4.54 ± 1.21）, （7.22 ± 1.58）. The joint function grading levels of sB7-H4 （μg/L）in 67 RA cases from level I to level IV were （ 29.37 ± 10.19）, （40.73 ± 13.24）, （52.32 ± 19.83）, （68.28 ± 24.46）; DAS28 score were （3.98 ± 1.16）, （5.72 ± 1.30）, （6.05 ± 1.62）, （7.83 ± 1.74）. The concentration of SB7-H4 was positively related with DAS28 score （r = 0.483, P〈0.01）. Conclusion The high expression of sBT-H4 RA in serum of RA cases was highly correlated with the RA disease activity index score and DAS28 and sB7-H4 can be used as an indicator for assessment of progress of rheumatoid arthritis disease.