Baspinar Sevgi, Kırnap Mehmet, Baspınar Osman, Dizdar Oguzhan Sıtkı, Kocer Derya
Department of Physical Treatment and Rehabilitation, Erciyes University Medical School, 38039, Kayseri, Turkey.
Department of Internal Medicine, Kayseri Training and Research Hospital, 38010, Kayseri, Turkey.
Rheumatol Int. 2016 Nov;36(11):1609-1616. doi: 10.1007/s00296-016-3536-x. Epub 2016 Jul 21.
Ankylosing spondylitis (AS) is a chronic inflammatory disorder that mainly affects the sacroiliac joints and axial skeleton. The aim of this study was to assess serum prolidase level (SPL) and its association with disease activity in patients with AS. This prospective study included 75 AS patients. Thirty age- and gender-matched healthy controls were enrolled. AS patients were considered as active if BASDAI score was ≥4 or inactive if BASDAI score was <4. There were 34 AS patients in the active group and 41 AS patients in the inactive group. Anti-TNF-monoclonal antibody treatment was started in patients in the active group. These active patients were reassessed 6 months later. BASDAI, ASDAS, visual analogue scale, short-form-general health survey questionnaire, C-reactive protein, erythrocyte sedimentation rate and SPL were measured in all AS patients before and after treatment. The SPL was significantly lower in inactive AS patients than in control group, and also, SPL was significantly lower in active AS patients than in inactive patients. All activity parameters were successful in separating active and inactive AS patients. However, the only parameter that could distinguish active patients from inactive patients was prolidase. The optimum cutoff point of SPL to identify patients with active AS was 23.13 ng/mL with sensitivity, specificity, positive predictive value and negative predictive value of 100 %. Serum prolidase level was successful in measuring disease activity and had as high sensitivity and specificity as BASDAI and was superior to other activity parameters.
强直性脊柱炎（AS）是一种主要影响骶髂关节和中轴骨骼的慢性炎症性疾病。本研究旨在评估血清脯氨酰寡肽酶水平（SPL）及其与AS患者疾病活动度的关系。这项前瞻性研究纳入了75例AS患者。招募了30名年龄和性别匹配的健康对照者。如果BASDAI评分≥4，则AS患者被视为疾病活动期；如果BASDAI评分<4，则视为疾病非活动期。活动组有34例AS患者，非活动组有41例AS患者。活动组患者开始接受抗TNF单克隆抗体治疗。6个月后对这些活动期患者进行重新评估。在所有AS患者治疗前后测量BASDAI、ASDAS、视觉模拟量表、简易一般健康调查问卷、C反应蛋白、红细胞沉降率和SPL。非活动期AS患者的SPL显著低于对照组，而且，活动期AS患者的SPL也显著低于非活动期患者。所有活动参数都成功区分了活动期和非活动期AS患者。然而，唯一能够区分活动期和非活动期患者的参数是脯氨酰寡肽酶。识别活动期AS患者的SPL最佳截断点为23.13 ng/mL，其敏感性、特异性、阳性预测值和阴性预测值均为100%。血清脯氨酰寡肽酶水平成功地测量了疾病活动度，其敏感性和特异性与BASDAI一样高，且优于其他活动参数。
