Gelsolin蛋白在类风湿性关节炎和系统性红斑狼疮的临床诊断及疾病活动度评价中的意义

目的:分析gelsolin蛋白对类风湿性关节炎(rheumatoid arthritis,RA)和系统性红斑狼疮(systemic lupus erythematosus,SLE)的临床诊断及疾病活动度评价的意义。方法:采集RA 30名和SLE 47名及健康人群50名的临床资料及血清标本,定量Western Blot法检测血清gelsolin水平。分析gelsolin蛋白与RA和SLE患者临床表现及疾病活动度的相关性。结果:RA、SLE和正常对照组之间性别、年龄、血红蛋白、血小板、血红细胞、血白细胞之间没有显著差异;RA患者出现CRP、转氨酶、RF、CCP异常的阳性率明显高于SLE患者(P0.05);而SLE患者出现白蛋白、尿蛋白、尿红细胞、尿素氮、ANA、肌酐异常增高的几率高于RA患者(P0.05)。gelsolin蛋白在SLE和RA血清中的含量均显著低于正常人(P0.05),且RA患者含量更低(P0.05)。gelsolin蛋白滴度与RA的疾病活动度无明显相关性(r=0.089,P=0.652),而与SLE的疾病活动度呈显著负相关(r=0.646,P0.05)。gelsolin蛋白正常组RA患者的转氨酶升高、CRP、RF、CCP阳性率均显著高于SLE患者(P0.05)。gelsolin蛋白降低组SLE患者的白蛋白、尿蛋白、尿红细胞、尿素氮、ANA、肌酐阳性率显著高于RA患者(P0.05)。结论:gelsolin蛋白滴度检测可作为RA和SLE临床辅助诊断手段,其滴度变化可作为SLE疾病活动度进展的预判指标。

The Value of Plasma Gelsolin Levels in Diagnosis and Disease ActivityEvaluation in Patients with Systemic Lupus Erythematosus and RheumatoidArthritis

Objective:To analyse the value of plasma gelsolin levels in patients with systemic lupus erythematosus andrheumatoid arthritis in diagnosis and disease activity evaluation.Methods:Plasma samples and clinical data were collected from 47 SLEpatients, 30 RA patients and 50 age- and gender-matched healthy individuals. Semiquantitative western blotting was used for measuringplasma gelsolin levels.Results:The plasma gelsolin levels in patients with SLE and RA were significantly decreased compared withhealthy controls (145.3± 40.4 versus 182.7± 38.3 mg/L and 100.8± 36 versus 182.7± 38.3 mg/L, P<0.001), and plasma gelsolin levelswere especially lower in RA than in SLE patients (100.8 ± 36 versus 145.3± 40.4 mg/L, P<0.001). An analysis of the clinical datashowed a significant negative correlation between plasma gelsolin levels and SLE Disease Activity Index (SLEDAI) scores (r=0.659,P<0.001) but no correlation between plasma gelsolin levels and RA disease index scores (DAS28, r=0.076, P=0.569).Conclusion:Thisstudy found significantly lower plasma gelsolin levels in patients with SLE and RA compared with healthy controls and documented asignificant negative correlation between plasma gelsolin levels and SLEDAI, which suggested the potential clinical application of plasmagelsolin in SLE diagnosis and disease activity evaluation.