广西医学

目的探讨强直性脊柱炎患者血清Caspase-1、正五聚蛋白3（PTX3）的表达水平及其临床意义。方法选取83例强直性脊柱炎患者（病例组）和60例健康体检者（对照组）作为研究对象。采用ELISA检测两组血清Caspase-1、PTX3、白细胞介素（IL）-17、IL-23、肿瘤坏死因子 α（TNF-α）水平，采用免疫透射比浊法检测两组血清C反应蛋白（CRP）水平，采用Bath强直性脊柱炎疾病活动指数（BASDAI）、改良的斯托克强直性脊柱炎脊柱评分（mSASSS）对病例组患者进行评估，并根据BASDAI评分将病例组患者分为疾病稳定期组（n=39）、疾病活动期组（n=44）。采用Pearson相关或Spearman秩相关分析血清Caspase-1、PTX3水平与疾病活动度及炎症指标的相关性，绘制受试者工作特征（ROC）曲线评估血清Caspase-1、PTX3水平对强直性脊柱炎的诊断价值。结果病例组血清Caspase-1、PTX3、CRP、IL-17、IL-23、TNF-α水平高于对照组（P＜0.05）。疾病活动期组患者血清Caspase-1、PTX3水平，以及BASDAI评分、mSASSS高于疾病稳定期组（P＜0.05）。病例组患者血清Caspase-1、PTX3水平与BASDAI评分、mSASSS，以及血清CRP、IL-17、IL-23、TNF-α水平呈正相关（P＜0.05）。ROC曲线结果显示，血清Caspase-1、PTX3水平诊断强直性脊柱炎的曲线下面积分别为0.793、0.772，两者联合诊断的曲线下面积为0.875，联合诊断的效能优于单一指标（P＜0.05）。结论强直性脊柱炎患者血清Caspase-1、PTX3水平升高，并与疾病活动度及炎症因子表达水平相关，两者均可用于强直性脊柱炎的辅助诊断，且联合检测诊断效能更高。

ObjectiveTo explore the expressions of serum Caspase-1 and pentraxin 3 (PTX3) in patients with ankylosing spondylitis and their clinical significance. MethodsA total of 83 patients with ankylosing spondylitis (the case group), and 60 healthy check-up individuals (the control group) were selected as the research subjects. The serum Caspase-1, PTX3, interleukin (IL)-17, IL-23, and tumor necrosis factor α (TNF-α) levels of both groups were detected by using the ELISA. The serum C-reactive protein (CRP) level of both groups was detected by employing the immunoturbidimetry. Patients in the case group were evaluated by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), and patients of the case group were divided into disease stable group (n=39) or disease active group (n=44) according to BASDAI score. The correlation of serum Caspase-1 and PTX3 levels with disease activity and inflammatory indexes was analyzed by using the Pearson correlation or Spearman rank correlation. The diagnostic value of serum Caspase-1, PTX3 levels for ankylosing spondylitis was evaluated by drawing the receiver operating characteristic (ROC) curve. ResultsThe levels of serum Caspase-1, PTX3, CRP, IL-17, IL-23, and TNF-α were higher in the case group than in the control group (P＜0.05). The levels of serum Caspase-1, PTX3, and BASDAI score, mSASSS were higher in the disease active group than in the disease stable group (P＜0.05). The levels of serum Caspase-1, PTX3 levels positively correlated with BASDAI score, mSASSS, and serum CRP, IL-17, IL-23 and TNF-α levels in the case group (P＜0.05). The results of ROC curve revealed that areas under the curve of serum Caspase-1 and PTX3 levels for diagnosing ankylosing spondylitis were 0.793 and 0.772, respectively, area under the curve of the combined diagnosis of the two was 0.875, and the efficiency of combined diagnosis was superior to single index (P＜0.05). ConclusionSerum Caspase-1 and PTX3 levels in patients with ankylosing spondylitis are elevated, and they are related to disease activity and expressions of inflammatory factors. Both of the two can be regarded as adjuvant diagnosis for ankylosing spondylitis, and the combined detection exerts higher diagnostic efficiency.