血清血管生成素-1 测量在早期类风湿关节炎诊断中的疗效。

Efficacy of serum angiopoietin-1 measurement in the diagnosis of early rheumatoid arthritis.

机构信息

Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

出版信息

Clin Exp Rheumatol. 2011 Jul-Aug;29(4):604-8. Epub 2011 Aug 30.

PMID:21906428

Abstract

OBJECTIVES

Previous studies showed that angiopoietin-1(Ang-1) expression was increased in the synovium in early rheumatoid arthritis (RA) patients. The present study was therefore designed to examine whether determination of serum Ang-1 might be effective in diagnosis of early RA.

METHODS

One hundred and five serum samples of RA (21 males, 84 females) were studied for serum Ang-1 level. Serum samples were also collected from other collagen diseases, including 35 cases of SLE, 29 cases of systemic sclerosis, 16 cases of polymyositis/dermatomyositis. Serum samples were additionally obtained from 34 patients who visited our clinic for evaluation of symmetrical polyarthritis with morning stiffness. After one year of follow-up, those patients who satisfied the ACR 1987 classification criteria for RA were defined as 'early RA'. Serum Ang-1 levels were measured by sandwich ELISA using anti-angiopoietin-1 antibodies (both monoclonal and polyclonal antibodies). Serum anti-CCP antibody and rheumatoid factor (RF) were measured by ELISA and by laser nepherometry, respectively.

RESULTS

Serum Ang-1 in RA patients was significantly higher than those in other collagen diseases. Serum Ang-1 levels in 50 normal healthy individuals were 5.8 ± 0.31 pg/ml (mean ± SEM). There was no significant difference in CRP and serum RF at the first visit between early RA patients and non-RA patients, whereas serum Ang-1 levels at the first visit were significantly higher in early RA (58.7 ± 17.9 pg/ml [mean ± SEM]) than those in non-RA (8.2 ± 4.5 pg/ml). ROC analysis revealed that serum Ang-1 (cut-off 23.91 pg/ml) could diagnose early RA at sensitivity 57.1% and specificity 84.6%, providing comparable area under the curve (0.71, 95% CI: 0.54-0.88) to that of serum anti-CCP antibody (0.72, 95% CI: 0.53-0.92). There was no significant correlation between anti-CCP antibody and Ang-1.

CONCLUSIONS

These results indicate that serum Ang-1 is as useful a marker for the diagnosis of early RA as serum anti-CCP antibody.

摘要

目的

既往研究显示，血管生成素-1（Ang-1）在早期类风湿关节炎（RA）患者的滑膜中表达增加。因此，本研究旨在探讨血清 Ang-1 测定对早期 RA 的诊断是否有效。

方法

研究了 105 例 RA 血清样本（男 21 例，女 84 例）的血清 Ang-1 水平。还收集了其他胶原疾病患者的血清样本，包括 35 例系统性红斑狼疮（SLE）、29 例系统性硬化症、16 例多发性肌炎/皮肌炎。另外还从 34 例因对称性多关节炎伴晨僵就诊于我院的患者中获得血清样本。经过 1 年的随访，符合 1987 年 ACR 分类标准的患者被定义为“早期 RA”。采用抗血管生成素-1 抗体（单克隆和多克隆抗体）的夹心 ELISA 法测定血清 Ang-1 水平。采用 ELISA 法和激光散射比浊法分别测定血清抗环瓜氨酸肽（抗 CCP）抗体和类风湿因子（RF）。

结果

RA 患者的血清 Ang-1 明显高于其他胶原疾病患者。50 名正常健康个体的血清 Ang-1 水平为 5.8±0.31 pg/ml（平均值±SEM）。早期 RA 患者与非 RA 患者在首次就诊时的 CRP 和血清 RF 无显著差异，而早期 RA 患者的血清 Ang-1 水平（58.7±17.9 pg/ml [平均值±SEM]）显著高于非 RA 患者（8.2±4.5 pg/ml）。ROC 分析显示，血清 Ang-1（截断值 23.91 pg/ml）对早期 RA 的诊断具有中等敏感性（57.1%）和特异性（84.6%），曲线下面积（0.71，95%CI：0.54-0.88）与血清抗 CCP 抗体（0.72，95%CI：0.53-0.92）相当。抗 CCP 抗体与 Ang-1 之间无显著相关性。