血清OPG和sRANKL评价强直性脊柱炎病情活动的价值
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Serum OPG and sRANKL in evaluating the disease activity of ankylosing spondylitis
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    目的:探讨护骨素(OPG)/核因子-资B受体活化因子配体(RANKL)系统与强直性脊柱炎病情活动的相关性和血清OPG与可溶性RANKL(sRANKL)在评价强直性脊柱炎病情活动中的价值-方法:采用酶联免疫吸附试验检测22例强直性脊柱炎活动期与22例强直性脊柱炎静止期患者血清OPG和sRANKL的水平,分析其与强直性脊柱炎病情活动的相关性-结果:①血清sRANKL水平及sRANKL/OPG比值在活动组均显著高于静止组,而OPG水平在两组间无统计学差异;②血清sRANKL水平和sRANKL/OPG比值与C反应蛋白-血沉-Bath强直性脊柱炎病情活动性指数和功能指数呈正相关;③最佳截断点上血清sRANKL(> 4.76 pmol/l)诊断强直性脊柱炎活动性的敏感性-特异性分别为86.4%-72.7%,而sRANKL/OPG比值(> 0.73)为90.9%和86.4%-结论:OPG/RANKL系统与强直性脊柱炎病情活动相关,血清sRANKL/OPG比值可作为评价强直性脊柱炎病情活动的临床指标-

    Abstract:

    Objective: To explore the relationship between osteoprotegerin(OPG)/ receptor activator of nuclear factor-кB ligand (RANKL) system and the disease activity of ankylosing spondylitis and investigate serum osteoprotegerin and soluble RANKL (sRANKL) in evaluating the disease activity of ankylosing spondylitis. Methods: According to the criterion of Bath ankylosing spondylitis disease activity index and erythrocyte sedimentation rate, 22 ankylosing spondylitis cases with definite activity(A group) were matched with 22 ankylosing spondylitis cases with no evident activity (Q group). Serum OPG and sRANKL levels were determined by enzyme-linked immunosorbent assay. Results: Compared with Q group, a significant increasing level of serum sRANKL and sRANKL/OPG ratio was identified in A group, whereas the levels of serum OPG were comparable between them. Serum levels of sRANKL and sRANKL/OPG ratio were positively correlated with C reactive protein, erythrocyte sedimentation rate, Bath ankylosing spondylitis disease activity index and Bath ankylosing spondylitis functional index. Moreover, according to Youden index of ROC curve, the best cut-off point of serum sRANKL (> 4.76 pmol/l) and sRANKL/OPG ratio (> 0.73) for diagnosing disease activity emerged. The diagnostic sensitivity and specificity of cut-off point of serum sRANKL were 86.4% and 72.7%, whereas that of sRANKL/OPG ratio reached 90.9% and 86.4%, respectively. Conclusion: OPG/RANKL system may be associated with the activity of ankylosing spondylitis. Serum sRANKL/OPG ratio can be a promising clinical index in evaluating the activity of ankylosing spondylitis.

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罗红玉.血清OPG和sRANKL评价强直性脊柱炎病情活动的价值[J].南京医科大学学报(自然科学版),2011,(10):1455-1458

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  • 收稿日期:2011-05-21
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