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目的:分析gelsolin蛋白对类风湿性关节炎(rheumatoid arthritis,RA)和系统性红斑狼疮(systemic lupus erythematosus,SLE)的临床诊断及疾病活动度评价的意义。方法:采集RA 30名和SLE 47名及健康人群50名的临床资料及血清标本,定量Western Blot法检测血清gelsolin水平。分析gelsolin蛋白与RA和SLE患者临床表现及疾病活动度的相关性。结果:RA、SLE和正常对照组之间性别、年龄、血红蛋白、血小板、血红细胞、血白细胞之间没有显著差异;RA患者出现CRP、转氨酶、RF、CCP异常的阳性率明显高于SLE患者(P<0.05);而SLE患者出现白蛋白、尿蛋白、尿红细胞、尿素氮、ANA、肌酐异常增高的几率高于RA患者(P<0.05)。gelsolin蛋白在SLE和RA血清中的含量均显著低于正常人(P<0.05),且RA患者含量更低(P<0.05)。gelsolin蛋白滴度与RA的疾病活动度无明显相关性(r=0.089,P=0.652),而与SLE的疾病活动度呈显著负相关(r=0.646,P<0.05)。gelsolin蛋白正常组RA患者的转氨酶升高、CRP、RF、CCP阳性率均显著高于SLE患者(P<0.05)。gelsolin蛋白降低组SLE患者的白蛋白、尿蛋白、尿红细胞、尿素氮、ANA、肌酐阳性率显著高于RA患者(P<0.05)。结论:gelsolin蛋白滴度检测可作为RA和SLE临床辅助诊断手段,其滴度变化可作为SLE疾病活动度进展的预判指标。
Objective: To analyze the significance of gelsolin in the clinical diagnosis and disease activity evaluation of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods: The clinical data and serum samples from 30 RA patients, 47 SLE patients and 50 healthy individuals were collected and serum gelsolin levels were determined by Western Blot. The correlation between gelsolin protein and clinical manifestations and disease activity in patients with RA and SLE was analyzed. Results: There was no significant difference in sex, age, hemoglobin, platelet, red blood cell and white blood cell between RA, SLE and normal controls. The positive rates of CRP, aminotransferase, RF and CCP in patients with RA were significantly higher than those in patients with SLE P <0.05). However, the incidence of albumin, urinary protein, urinary red blood cells, urea nitrogen, ANA and creatinine were significantly higher in patients with SLE than those in patients with RA (P <0.05). The contents of gelsolin in SLE and RA sera were significantly lower than those in normal people (P <0.05), and the content of gelsolin in RA patients was lower (P <0.05). The gelsolin protein titer had no significant correlation with the disease activity of RA (r = 0.089, P = 0.652), but negatively correlated with the disease activity of SLE (r = 0.646, P <0.05). The patients with gelsolin normal RA had elevated transaminases, the positive rates of CRP, RF and CCP were significantly higher than those with SLE (P <0.05). The positive rates of albumin, urinary protein, urinary erythrocyte, urea nitrogen, ANA and creatinine in SLE patients with gelsolin decreased significantly (P <0.05). Conclusion: The detection of gelsolin protein titer can be used as a clinical assistant diagnostic tool for RA and SLE. The titer of gelsolin can be used as a predictor of SLE disease activity.