腺苷脱氨酶及同工酶对自身免疫病诊断和病情监测的作用

摘要 目的：检测腺苷脱氨酶(ADA)及其同工酶在自身免疫病患者血清中的变化，探讨其诊断和病情监测作用。方法：收集70例系统性红斑狼疮（SLE）、114例类风湿性关节炎(RA)、55例强直性脊柱炎(AS)、及其年龄性别对应的健康血清标本。测定血清总ADA（tADA）、ADA1及ADA2活性。ROC曲线分析其诊断价值。结果：与健康对照相比，ADA活性在SLE患者血清中显著升高[tADA：15（12，20）vs 8（7，10）U/L；ADA1：3.5（2，5）vs 3（2，3）U/L；ADA2：11（8，15）vs 6（5，7）U/L；P<0.01）]。与健康对照相比，RA患者血清中tADA和ADA1活性无显著变化(P>0.05)，ADA2活性水平升高[8（5.25，10）vs 7（5，9）U/L，P<0.05）]；与健康对照相比，AS患者血清中tADA和ADA1活性无显著变化(P>0.05)，ADA2活性升高[7（5，9）vs 6（5，7）U/L，P<0.05）]。ROC分析显示tADA及ADA2对SLE具有较好诊断价值（tADA：88.6%特异性、77.1%敏感性；ADA2：92.9%特异性、68.6%敏感性）。ADA活性对RA及AS患者无诊断价值。spearman相关性分析显示，tADA活性与SLE患者疾病活动度有一定正相关性（r=0.303，P=0.011)。结论：血清tADA活性检测可作为SLE辅助诊断和病情监测指标。

Effects of Adenosine Deaminase and Isozyme on Diagnosis and Disease Activity in Patients with Autoimmune Diseases

ABSTRACT Objective: To investigate the changes and diagnostic value of serum adenosine deaminase (ADA) and its isoenzymes in serum of patients with autoimmune diseases. Methods: Patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) patients and ankylosing spondylitis (AS) were included in this study. Serum ADA activity were detected in 70 SLE, 114 RA, 55 AS and their sex & age matched healthy controls. A receiver operating characteristic (ROC) curve analysis was applied to evaluate the diagnostic performance of serum ADA activity. Results: Compared with healthy controls, ADA activity was significantly increased in the serum of SLE patients (tADA activity: 15 (12,20) vs 8 (7,10) U/L. ADA1 activity: 3.5 (2,5) vs 3 (2,3) U/L; ADA2 activity: 11 (8,15) vs 6 (5,7) U/L; P<0.01). Compared with the healthy controls, serum ADA2 activity were increased in RA patients(8 (5.25,10) vs 7 (5,9) U/L, P<0.05), while there was no significant change in serum tADA and ADA1 activity in RA patients (P>0.05). And moreover, serum ADA2 activity was increased in AS patients (7 (5,9) vs 6 (5,7) U/L, P<0.05), while there were no significant change in serum tADA and ADA1 activity in AS patients (P>0.05). ROC analysis showed that tADA and ADA2 activity could be used in diagnosing SLE (tADA: 88.6% specificity, 77.1% sensitivity; ADA2:92.9% specificity, 68.6% sensitivity). Spearman correlation analysis showed that serum tADA activity was positively correlated with disease activity (SLEDAI) in SLE patients (r=0.303, P=0.011). Conclusion: Serum tADA activity can be used as a potential diagnostic and monitoring marker for SLE patients.