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高敏心肌肌钙蛋白 T 与炎症性关节炎患者的疾病活动相关。

High-sensitivity cardiac troponin T is associated with disease activity in patients with inflammatory arthritis.

机构信息

Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway.

Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

PLoS One. 2023 Feb 10;18(2):e0281155. doi: 10.1371/journal.pone.0281155. eCollection 2023.

Abstract

OBJECTIVE

To investigate whether high-sensitivity cardiac troponin T (hsTnT) correlates to markers of disease activity in inflammatory arthritis (IA), and whether antirheumatic treatment influences hsTnT levels.

METHODS

We assessed 115 patients with active IA (64 rheumatoid arthritis (RA), 31 psoriatic arthritis and 20 ankylosing spondylitis) before and after using methotrexate (MTX) alone or tumor necrosis factor inhibitor (TNFi) with or without MTX co-medication (TNFi±MTX). All patients starting with TNFi had been previously unsuccessfully treated with MTX monotherapy. HsTnT (measured in serum by electro-chemiluminescence immunoassay (Roche Elecsys® Troponin T- high-sensitivity)), and other clinical and laboratory parameters were evaluated at baseline, and after 6 weeks and 6 months of treatment.

RESULTS

Of markers of disease activity, baseline levels of hsTnT positively correlated with Physicians' Global Assessment Score of disease activity in the total patient cohort (p = 0.039). In RA group, hsTnT positively correlated with swollen joints, Disease Activity Score for 28 joints with ESR and serum tumor necrosis factor levels (p = 0.025, p = 0.008, p = 0.01, respectively). Median hsTnT at baseline was 5.0 ng/L, and did not change significantly at 6-week visit (6.0 ng/L, p = 0.37) and 6-month visit (6.0 ng/L, p = 0.18) with either antirheumatic therapy.

CONCLUSIONS

HsTnT levels were associated with inflammatory markers for IA disease activity. However, while inflammatory markers significantly improved after antirheumatic treatment, hsTnT did not change during the 6-month follow-up period.

摘要

目的

探讨高敏心肌肌钙蛋白 T(hsTnT)与炎症性关节炎(IA)疾病活动标志物的相关性,以及抗风湿治疗是否影响 hsTnT 水平。

方法

我们评估了 115 例活动性 IA 患者(64 例类风湿关节炎(RA)、31 例银屑病关节炎和 20 例强直性脊柱炎)在单独使用甲氨蝶呤(MTX)或肿瘤坏死因子抑制剂(TNFi)治疗前后的 hsTnT(采用电化学发光免疫分析法(罗氏 Elecsys Troponin T-高敏)在血清中检测)和其他临床及实验室参数,所有开始使用 TNFi 的患者之前均已接受 MTX 单药治疗失败。hsTnT(在总患者队列中与医师总体疾病活动评估呈正相关(p = 0.039)。在 RA 组中,hsTnT 与肿胀关节、红细胞沉降率和血清肿瘤坏死因子水平的 28 关节疾病活动评分呈正相关(p = 0.025,p = 0.008,p = 0.01)。基线时 hsTnT 的中位数为 5.0ng/L,在 6 周时(6.0ng/L,p = 0.37)和 6 个月时(6.0ng/L,p = 0.18),无论是接受抗风湿治疗,hsTnT 均无明显变化。

结论

hsTnT 水平与 IA 疾病活动的炎症标志物相关。然而,尽管抗风湿治疗后炎症标志物明显改善,但在 6 个月的随访期间,hsTnT 并未发生变化。

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