血清淀粉样蛋白A水平在幼年特发性关节炎疾病活动度评估中的价值分析

冯烨; 张宇; 周娟; 赵晓东; 唐雪梅

doi:10.16016/j.1000-5404.201704033

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血清淀粉样蛋白A水平在幼年特发性关节炎疾病活动度评估中的价值分析

临床医学 | 更新时间：2026-01-09

- 血清淀粉样蛋白A水平在幼年特发性关节炎疾病活动度评估中的价值分析
- Clinical value of serum amyloid A in assessment of disease activity for juvenile idiopathic arthritis
- 第三军医大学学报 2017年39卷第19期页码：1933-1938
- 作者机构：
  
  400014 重庆，重庆医科大学附属儿童医院风湿免疫科，儿童发育疾病研究教育部重点实验室，儿童发育重大疾病国家国际科技合作基地，儿童感染免疫重庆市重点实验室
- 作者简介：
  
  [ 唐雪梅，E-mail:tangxuemei2008@163.com TANG Xuemei, E-mail:tangxuemei2008@163.com
- 基金信息：
  
  重庆市自然科学基金一般项目(CSTC2012jiA10077);重庆市科学技术委员会科研项目(CSTC2014jcyjA10023);重庆市卫生和计划生育委员会一般项目(2016MSXM033)
- DOI：10.16016/j.1000-5404.201704033
  中图分类号： R181.23;R446.112;R726.843
- 收稿：2017-04-10，
  
  修回：2017-06-26，
  
  纸质出版：2017-10-15
- 稿件说明：
移动端阅览
冯烨, 张宇, 周娟, 等. 血清淀粉样蛋白A水平在幼年特发性关节炎疾病活动度评估中的价值分析[J]. 第三军医大学学报, 2017,39(19):1933-1938.

Ye FENG, Yu ZHANG, Juan ZHOU, et al. Clinical value of serum amyloid A in assessment of disease activity for juvenile idiopathic arthritis[J]. Journal of Third Military Medical University, 2017, 39(19): 1933-1938.
冯烨, 张宇, 周娟, 等. 血清淀粉样蛋白A水平在幼年特发性关节炎疾病活动度评估中的价值分析[J]. 第三军医大学学报, 2017,39(19):1933-1938. DOI： 10.16016/j.1000-5404.201704033.

Ye FENG, Yu ZHANG, Juan ZHOU, et al. Clinical value of serum amyloid A in assessment of disease activity for juvenile idiopathic arthritis[J]. Journal of Third Military Medical University, 2017, 39(19): 1933-1938. DOI： 10.16016/j.1000-5404.201704033.

摘要

目的

研究血清淀粉样蛋白A(serum amyloid A protein

SAA)在幼年特发性关节炎(juvenile idiopathic arthritis

JIA)疾病活动度评估中的临床应用价值。

方法

选取JIA患儿102例收集其血常规、SAA、血沉(erythrocyte sedimentation rate

ESR)、C反应蛋白(C-reactive protein

CRP)及骨密度结果，采用幼年关节炎疾病活动评分(juvenile arthritis disease activity score with 27 joints

JADAS-27) 对疾病活动程度进行评估并比较其相关性。采用便利抽样法选取年龄性别成组匹配的健康体检儿童51例作为对照组。

结果

JIA患儿血清SAA水平显著高于健康对照组(96.1 mg/L

16.8 mg/L，

0.05)。血清SAA水平在全身型JIA患儿中较关节型患儿升高明显。活动期JIA患儿SAA水平较稳定期显著升高。SAA与CRP(

=0.819)、ESR(

=0.712) 均呈显著正相关(

0.01)。SAA的ROC曲线下面积(area under the ROC curve

AUC)达0.795，仅次于血沉(AUC = 0.860)，较CRP及其他指标更高。当SAA或血小板任意一项异常，

且二者之和大于354时，判断疾病活动敏感性达0.71，特异性达0.84。JADAS-27评分与SAA、CRP均呈低度相关(

值0.33-0.48，

0.01)

与血沉呈中度相关(

=0.64)。疾病高度活动状态下，SAA显著升高。

结论

SAA，尤其是SAA联合血小板计数增高，有望作为新的JIA疾病活动度评估指标，值得在临床进一步推广。

Abstract

Objective

To investigate the clinical value of serum amyloid A (SAA) in the assessment of the disease activity of juvenile idiopathic arthritis (JIA).

Methods

A total of 102 JIA children admitted in our department from February 2016 to February 2017 were enrolled in this study. Their results of blood routine test

SAA level

erythrocyte sedimentation rate (ESR)

bone mineral density

and C-reactive protein (CRP) level were collected. The disease activity was evaluated by the juvenile arthritis disease activity score with 27-joints reduced count (JADAS-27). Another 51 age-and sex-matched healthy children taking physical examination in our hospital in the same period were selected as control group.

Results

The SAA level was significantly higher in the JIA children than the control (96.1

16.8 mg/L

0.05). Compared with the joint type of JIA

SAA levels were obviously elevated in the systemic JIA. And the level was notably higher in the children with active JIA than those in the stable state. SAA level was positively correlated with CRP level (

=0.819

0.01) and ESR (

=0.712

0.01). The area under the receiver operative characteristic curve (AUC) of SAA was 0.795

which was lower than that of ESR (AUC=0.860)

but higher than those of CRP and other indexes. When SAA or platelet was abnormal

and the sum of the 2 values was greater than 354

the sensitivity of disease activity was 0.71

and the specificity was 0.84. JADAS-27 score was mildly correlated with SAA level an

d CRP level (

=0.33~0.48

0.01)

and was moderately correlated with ESR (

=0.64). SAA level was significantly higher in the JIA children with high disease activity.

Conclusion

SAA

especially combined with increased platelet count

is expected to become a new assessment indicator for JIA disease activity

and worth of further promotion in clinical practice

关键词

Keywords

references

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