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| sTREM -1、TNF-α、IL-6在老年类风湿性关节炎诊断中的应用 |
| Application of sTREM-1，TNF-α，and IL-6 in the diagnosis of rheumatoid arthritis in the elderly |
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| DOI：10.3969/j.issn.1006.7108.2015.09.014 |
| 中文关键词: 老年类风湿性关节炎 肿瘤坏死因子-α 可溶性髓样细胞触发受体-1；白细胞介素-6 ROC曲线 |
| 英文关键词:Elderly onset rheumatoid arthritis Tumor necrosis factor-α Triggering receptor expressed on myeloid cells4 Interleukin-6 Receiver operating characteristic curve |
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| 中文摘要: |
| 目的 探讨可溶性髓样细胞触发受体-1 (sTREM-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)在老年类风湿性关节炎(EORA)患者临床诊断中的意义。方法 选择42例活动期EORA、38例稳定期EORA患者、37例其他风湿免疫系统疾病患者(疾病对照组)及34例健康对照者，通过ELISA法检测血清TNF-α、sTREM-1、IL-6表达水平，绘制ROC曲线分析评价三种细胞炎性因子诊断EORA的特异性、敏感性及诊断效能。结果 EORA患者中，活动期和稳定期的TNF-α、sTREM-1、IL-6表达水平均高于健康对照组，（P <0. 05)，且活动期TNF-α、sTREM-1、IL-6水平均高于稳定期，（P < 0. 05)。与疾病对照组比较，活动期RA组三项检测指标均不具有统计学意义(P >0. 05)。活动期RA患者STREM-1水平与TNF-α、IL-6及反应疾病活动的指标C反应蛋白（CRP)、血沉（ESR)水平之间均具有正相关性(P <0. 05)。通过比较ROC曲线下面积大小，STREM-1的诊断效能和TNF-α接近，敏感性依次为91. 4%、89. 5%，特异性依次为89. 3%、92. 6%。STREM-1、TNF-α和IL-6三项指标联合检测的诊断特异性最高为98. 3%。结论 血清中sTREM-1、TNF-α和IL-6水平测定有助于EORA患者的临床诊断，STREM-1可能成为EORA活动性新指标，三项指标联合检测可提高其特异性。 |
| 英文摘要: |
| Objective To evaluate the significance of serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1)，tumor necrosis factor-α(TNF-α)，and interleukin-6 (IL-6) in the diagnosis of elderly onset rheumatoid arthritis (EORA). Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of sTREM-1，TNF-α，and IL-6 in 42 patients with the active stage of EORA，38 patients with the inactive stage of EORA，37 patients with other antoimmune disease，and 34 healthy subjects. The receiver operating characteristic ( ROC) curves were used to analyze the specificity，sensitivity and diagnostic efficiency. Results The serum levels of sTREM-1，TNF-α，and IL-6 were significantly higher in the active phase and the inactive phase of EORA than in healthy controls (P < 0. 05)，and they were significantly higher in the active phase of EORA than in the inactive phase of EORA (P < 0. 05). Compared with the other antoimmune diseases group， the serum levels of sTREM-1，TNF-α，and IL-6 were no significant difference in the active phase of EORA (P > 0. 05). The serum level of sTREM-1 in the active phase of EORA was positively correlated with TNF-α，IL-6，CRP，and ESR levels (P < 0. 05). The diagnostic efficiency of sTREM-1 was similar to that of TNF-α by comparison of the area under the curve of ROC. The sensitivity and specificity of sTREM-1 and TNF-α in diagnosis of EORA were 91. 4% and 89. 5%，89. 3% and 92. 6%，respectively. The highest specificity of combined detection with TREM-1，TNF-α，and IL-6 was 98. 3%. Conclusion Detection of serum sTREM- 1，TNF-α，and IL-6 levels is helpful in the diagnosis of EORA. sTREM-1 is a potent serum marker for clinical activity of EORA. Furthermore，combined detection with sTREM-1，TNF-α，and IL-6 increases the specificity of the diagnosis of EORA. |
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