血清淀粉样蛋白A (SAA)升高的大动脉炎(TA)患者免疫炎症状态

 目的  对伴有血清淀粉样蛋白A(serum amyloid A, SAA)升高的大动脉炎(Takayasu's arteritis, TA)患者的临床特征、免疫炎症状态和疾病活动性进行分析。方法  收集TA患者80例,比较SAA升高组和正常组患者一般资料、病情活动、炎症指标、细胞因子及用药情况差异,采用t检验、秩和检验和Spearman's相关系数分析进行统计学分析。结果  与SAA正常组相比,SAA升高组有更多患者Kerr评分≥2(86.44% vs.61.9%, P=0.036),红细胞沉降率(erythrocyte sedimentation rate,ESR)［(47.84±34.60) mg/L vs. (18.86±15.87) mg/L, P＜0.001］、超敏C反应蛋白(high-sensitivity C-reactive protein, hs-CRP)［17.42(5.20~36.90)mg/L vs.1.80(0.75~4.05)mg/L, P＜0.001］、血小板数［(295.00±95.60)×109/L vs.(240.85±75.78)×109/L,P=0.025］、血清球蛋白水平［(29.05±6.49)g/L vs. (24.98±4.33)g/L, P=0.002］、IgG［(13.37±4.52)g/L vs.(11.63±2.63)g/L, P=0.048］、补体C3［(1.26±0.26) g/L vs. (1.03±0.20) g/L,P=0.002］、C4［0.25(0.21~0.29)g/L vs. 0.20(0.14~0.23)g/L,P=0.008］及IL-6水平［(10.64±8.93) pg/mL vs. (3.88±2.72) pg/mL, P=0.001］显著高于SAA正常组。结论  SAA升高的TA患者炎症指标和疾病活动性更高,SAA检测有助于了解炎症和疾病状况。

Inflammatory state of patients with Takayasu's arteritis (TA) complicated with elevated serum amyloid A (SAA)

Objective  To analyze the clinical feature, inflammatory state and disease activity of patients with Takayasu's arteritis (TA) complicated with elevated serum amyloid A (SSA). Methods  Among 80 TA patients, the differences in clinical data, disease activity, inflammatory markers, cytokines and drug utilization were compared between SAA-elevating group and SAA-normal group by t test, rank sum test and Spearman's correlation analysis. Results  SAA-elevating group had higher portion of Kerr's index≥2 (86.44% vs. 61.9%, P=0.036), higher level of erythrocyte sedimentation rate (ESR) ［(47.84±34.60) mg/L vs. (18.86±15.87) mg/L, P＜0.001］ and high sensitivity C-reactive protein (hs-CRP) ［17.42(5.20-36.90) mg/L vs.1.80(0.75-4.05) mg/L, P＜0.001］, platelet ［(295.00±95.60)×109/L vs. (240.85±75.78)×109/L, P=0.025］, globulin ［(29.05±6.49)g/L vs. (24.98±4.33) g/L, P=0.002］, IgG ［(13.37±4.52) g/L vs. (11.63±2.63)g/L, P=0.048］, C3 ［(1.26±0.26)g/L vs. (1.03±0.20)g/L, P=0.002］, C4 ［0.25(0.21-0.29) g/L vs. 0.20(0.14-0.23) g/L, P=0.008］ and IL-6［(10.64±8.93) pg/mL vs. (3.88±2.72) pg/mL, P=0.001］ compared with SAA-normal group. Conclusions  TA patients complicated with elevated SSA have higher inflammatory index and disease activity, thus examination of SAA is necessary to reveal the inflammatory and disease status.