血清淀粉样蛋白A水平在幼年特发性关节炎疾病活动度评估中的价值分析

发布时间：2018-02-24 00:31

本文关键词： 血清淀粉样蛋白A 幼年特发性关节炎幼年关节炎疾病活动评分- 疾病活动程度评估　出处：《第三军医大学学报》2017年19期 　论文类型：期刊论文

【摘要】：目的研究血清淀粉样蛋白A(serum amyloid A protein,SAA)在幼年特发性关节炎(juvenile idiopathic arthritis,JIA)疾病活动度评估中的临床应用价值。方法选取JIA患儿102例收集其血常规、SAA、血沉(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)及骨密度结果,采用幼年关节炎疾病活动评分(juvenile arthritis disease activity score with 27 joints,JADAS-27)对疾病活动程度进行评估并比较其相关性。采用便利抽样法选取年龄性别成组匹配的健康体检儿童51例作为对照组。结果 JIA患儿血清SAA水平显著高于健康对照组(96.1 mg/L vs 16.8 mg/L,P0.05)。血清SAA水平在全身型JIA患儿中较关节型患儿升高明显。活动期JIA患儿SAA水平较稳定期显著升高。SAA与CRP(r=0.819)、ESR(r=0.712)均呈显著正相关(P0.01)。SAA的ROC曲线下面积(area under the ROC curve,AUC)达0.795,仅次于血沉(AUC=0.860),较CRP及其他指标更高。当SAA或血小板任意一项异常,且二者之和大于354时,判断疾病活动敏感性达0.71,特异性达0.84。JADAS-27评分与SAA、CRP均呈低度相关(r值0.33-0.48,P0.01),与血沉呈中度相关(r=0.64)。疾病高度活动状态下,SAA显著升高。结论 SAA,尤其是SAA联合血小板计数增高,有望作为新的JIA疾病活动度评估指标,值得在临床进一步推广。
[Abstract]:Objective to study the clinical value of serum amyloid protein amyloid A protein (SAA) in evaluating the disease activity of juvenile idiopathic arthritis (JIA). Methods 102 children with JIA were selected to collect their blood routine examination (SAA), erythrocyte sedimentation erythrocyte erythrocyte (sedimentation ratetate), C-reactive protein C-reactive protein (C-reactive protein CRP) and bone mineral density (BMD). Juvenile arthritis disease activity score with 27 joints27 (JADAS-27) were used to evaluate the degree of disease activity and to compare its correlation. 51 healthy children matched by age and sex were selected as control group by convenient sampling method. Results Serum SAA levels in JIA patients were significantly higher than those in healthy controls (96.1 mg/L vs 16.8 mg / L P 0.05). Serum SAA levels were significantly higher in children with systemic JIA than in children with articular type. SAA levels in active JIA children were significantly higher than those in stable phase. The area under the ROC curve of under the ROC (0.712) was 0.795, second only to ESR 0.860, higher than that of CRP and other indexes. When SAA or platelet was abnormal, And when the sum of the two is greater than 354, The sensitivity of disease activity was 0.71, the specificity was 0.84.JADAS-27 and SAAA-CRP was low correlation r value 0.33-0.48g P 0.01g, and the correlation with ESR was 0.64%. Conclusion SAA, especially SAA combined with platelet count, was significantly increased in the highly active state of disease. It is expected to be a new indicator of JIA disease activity, and it is worthy of further promotion in clinical practice.
【作者单位】：重庆医科大学附属儿童医院风湿免疫科儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿童感染免疫重庆市重点实验室;
【基金】：重庆市自然科学基金一般项目(CSTC2012jiA10077) 重庆市科学技术委员会科研项目(CSTC2014jcyjA10023) 重庆市卫生和计划生育委员会一般项目(2016MSXM033)~~
【分类号】：R725.9

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