类风湿关节炎患者血清Dickkopf-1表达与疾病活动的相关性研究

目的:检测类风湿关节炎(RA)患者血清中的Dickkopf-1(DKK-1)水平,并探讨其与RA疾病活动的关系。方法:选择2017年10月—2019年12月在山西省汾阳医院风湿免疫科门诊及住院治疗的RA患者44例。详细记录患者治疗前后的临床特点及实验室检测结果。基于28个关节的肿痛情况进行疾病活动性评价(即DAS28评分)。采用酶联免疫吸附法(ELISA)检测治疗前后血清中DKK-1水平。结果:RA患者血清中DKK-1与压痛关节数(TJC)、肿胀关节数(SJC)、DAS28呈正相关(分别为r=0.309,P=0.049;r=0.320,P=0.042;r=0.311,P=0.048),与红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、年龄无相关性;治疗前DKK-1在RA患者血清中的表达为(6.62±2.29)μg/L,治疗后为(3.79±1.26)μg/L,两者比较差异有统计学意义(t=7.16,P<0.001)。治疗后TJC,SJC,ESR,CRP,RF,DAS28均较治疗前下降(分别为t=53.14,P<0.001;t=47.78,P<0.001;t=71.83,P=0.022;t=75.59,P=0.049;t=77.60,P=0.032;t=79.29,P<0.001)。结论:DKK-1与RA疾病活动性呈正相关,可视为RA疾病活动的生物标志物。

Study on the correlation between serum Dickkopf-1 level and disease activity in patients with rheumatoid arthritis

Objective:To detect Dickkopf-1(DKK-1)level and to study the relationship between serum DKK-1 and disease activity in patients with rheumatoid arthritis(RA).Methods:All 44 RA patients from October 2017 to December 2019 in the department of rheumatology and immunology of Fenyang Hospital in Shanxi Province were collected.Their clinical characteristics were recorded in detail,and laboratory tests were conducted before and after treatment for 3 months.Disease activity was evaluated by disease activity score according to twenty-eight joints involvement(DAS28)at the same time point.Serum DKK-1 level was detected by enzyme linked immunosorbent assay(ELISA).Results:Serum DKK-1 of RA patients was positively correlated with tender joint count(TJC),swollen joint count(SJC)and DAS28(r=0.309,P=0.049;r=0.320,P=0.042;r=0.311,P=0.048).DKK-1 was not correlated with electronspin resonance(ESR),C reactive protein(CRP),rheumatoid factor(RF)or age.Serum DKK-1 was(6.62±2.29)μg/L before treatment and(3.79±1.26)μg/L after treatment.The difference was statistically significant(t=7.16,P<0.001).TJC,SJC,ESR,CRP,RF and DAS28 all decreased after treatment compared with that before treatment(t=53.14,P<0.001;t=47.78,P<0.001;t=71.83,P=0.022;t=75.59,P=0.049;t=77.60,P=0.032;t=79.29,P<0.001).Conclusion:Serum DKK-1 is positively correlated with disease activity score and could be used as a biomarker of disease activity in RA.