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目的探讨血清软骨寡聚基质蛋白(COMP)水平与脊柱关节病(SpA)患者病情活动及骨破坏的相关性。方法采用酶联免疫吸附试验(ELISA)方法,检测38例SpA患者、18例正常人及10例注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(商品名益赛普)治疗前后SpA患者血清COMP水平、血沉及C反应蛋白,并行骶髂关节CT分级,记录患者BAS、ASDAS评分及夜间脊柱痛视觉评分(VAS),分析其与COMP的相关性。结果 SpA患者组血清COMP水平为(30.835±8.539)ng/ml,明显高于正常对照组的(12.639±2.939)ng/ml(P<0.01);病情活动组血清COMP水平为(34.168±7.988)ng/ml,明显高于非活动组的(25.122±6.243)ng/ml(P=0.01);治疗后SpA患者血清COMP水平为(17.670±7.199)ng/ml,较治疗前的(35.645±7.381)ng/ml明显下降(P<0.01)。COMP水平与夜间脊柱痛VAS、ESR、CRP及骶髂关节CT分级正相关,与BSADAI、BSAFI、ASDAS-ESR、ASDAS-CRP正相关,与年龄、病程、BASMI及外周关节受累无显著相关。结论 SpA患者血清COMP高水平存在提示病情活动,可能预示明显骨质破坏,血清COMP有可能成为判断SpA疾病活动性和疗效的指标。
Objective To investigate the correlation between serum cartilage oligomeric matrix protein (COMP) levels and disease activity and bone destruction in patients with spondyloarthropathies (SpA). Methods The levels of SpA in 38 cases of SpA, 18 cases of normal and 10 cases of recombinant human type Ⅱ tumor necrosis factor receptor-antibody fusion protein (trade name Yi-Saipu) were detected by enzyme linked immunosorbent assay (ELISA) The levels of COMP, ESR and C-reactive protein in patients were graded. The patients underwent sacroiliac joint CT grading. The BAS, ASDAS score and nighttime visual acuity score (VAS) were recorded and their correlation with COMP was analyzed. Results The level of COMP in serum of patients with SpA was (30.835 ± 8.539) ng / ml, which was significantly higher than that of the normal controls (12.639 ± 2.939) ng / ml (P <0.01) (25.122 ± 6.243) ng / ml (P = 0.01). After treatment, the level of COMP in serum of SpA patients was (17.670 ± 7.199) ng / ml, which was significantly higher than that before treatment (35.645 ± 7.381 ) ng / ml decreased significantly (P <0.01). COMP levels were positively correlated with nighttime spine pain VAS, ESR, CRP and sacroiliac joint CT grade, positively correlated with BSADAI, BSAFI, ASDAS-ESR and ASDAS-CRP, but not with age, course of disease, BASMI and peripheral joint involvement. Conclusions The high level of serum COMP in patients with SpA suggests the activity of the disease, which may indicate the obvious bone destruction. The serum COMP may be an index to judge the activity and efficacy of SpA.