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目的分析类风湿关节炎(Rheumatoid arthritis,RA)可溶性B7-H4(sB7-H4)和病情活动指标DAS28(Disease activity score in 28 joints,DAS28)在治疗前后的变化及相关性,探讨sB7-H4对类风湿关节炎功能损害的评估价值。方法92例RA按病情活动分组,病情稳定组13例,低度活动组12例,中度活动组25例,高度活动组42例。67例RA中度、高度活动组按关节功能分级,1级11例、2级22例、3级24例、4级10例。92例类风湿关节炎酶联免疫吸附试验(ELISA)测定sB7-H4,魏氏法测定血沉(Erythrocyte sedimentation rate,ESR),依据血沉和相关数据计算得出DAS28评分。结果92例RA的sB7-H4(μg/L)治疗前后浓度分别为36.58±12.88、20.73±8.35,DAS28评分治疗前后分别为5.03±1.37、2.62±0.61。治疗前92例RA病情稳定组、低度活动组、中度活动组、高度活动组sB7-H4(μg/L)分别为12.26±4.14、20.55±8.83、32.64±11.52、63.50±23.71;DAS28评分分别为1.84±0.49、3.11±0.76、4.54±1.21、7.22±1.58。67例RA关节功能分级1级、2级、3级、4级sB7-H4(μg/L)分别为29.37±10.19、40.73±13.24、52.32±19.83、68.28±24.46;DAS28评分分别为3.98±1.16、5.72±1.30、6.05±1.62、7.83±1.74。sB7-H4与DAS28评分呈正相关(r为0.483,P<0.01)。结论sB7-H4在RA血清中高表达,与RA病情活动指标DAS28评分高度相关,sB7-H4可作为类风湿关节炎疾病进展的评价指标。
Objective To analyze the changes and correlations of soluble activity of B7-H4 (sB7-H4) and disease activity score (DAS28) in rheumatoid arthritis (RA) patients before and after treatment, Rheumatoid arthritis functional impairment assessment value. Methods Ninety-two RA patients were divided into two groups according to their disease activities: 13 patients in stable condition, 12 patients in low activity group, 25 patients in moderate activity group and 42 patients in high activity group. Sixty-seven patients with moderate to severe RA were classified according to their joint function, including grade 1 in 11, grade 2 in 22, grade 3 in 24, and grade 4 in 10. Ninety-two patients with rheumatoid arthritis were tested for sB7-H4 by ELISA and Erythrocyte sedimentation rate (ESR) was measured by Weiss method. The DAS28 score was calculated based on ESR and related data. Results The serum concentrations of sB7-H4 (μg / L) in 92 RA patients before and after treatment were 36.58 ± 12.88 and 20.73 ± 8.35, respectively. The DAS28 scores before and after treatment were 5.03 ± 1.37 and 2.62 ± 0.61, respectively. The serum levels of sB7-H4 (μg / L) were 12.26 ± 4.14, 20.55 ± 8.83, 32.64 ± 11.52 and 63.50 ± 23.71 in 92 patients with stable RA before treatment, respectively. The scores of DAS28 (1.84 ± 0.49, 3.11 ± 0.76, 4.54 ± 1.21, 7.22 ± 1.58, respectively). The levels of sB7-H4 (μg / L) in grade 2, grade 3 and grade 4 in RA patients were 29.37 ± 10.19 and 40.73 ± 13.24,52.32 ± 19.83,68.28 ± 24.46; DAS28 scores were 3.98 ± 1.16,5.72 ± 1.30,6.05 ± 1.62,7.83 ± 1.74 respectively. There was a positive correlation between sB7-H4 and DAS28 score (r = 0.483, P <0.01). Conclusion The expression of sB7-H4 in RA serum is highly correlated with DAS28 score of RA activity index, and sB7-H4 can be used as an evaluation index of disease progression of rheumatoid arthritis.