【摘要】 目的比较强直性脊柱炎(AS)患者和健康者血清Dickkopf-1(DKK-1)的水平,探讨TNF-α抑制剂对AS患者血清DKK-1水平的影响。方法选取56例AS患者(AS组)和40例健康志愿者(对照组)。在用TNF-α抑制剂治疗前和治疗后3个月,测定AS组患者血清DKK-1、骨钙蛋白、骨保护素以及Ⅰ型胶原C-末端肽(CTX-1)水平,并对AS患者的Bath强直性脊柱炎疾病活动指数(BASDAI)进行评估。对照组人群进行同样的4项生化指标的检测。结果 AS组血清DKK-1水平低于对照组(P<0.05),AS组血清骨钙蛋白和骨保护素水平均高于对照组(P<0.05)。相比治疗前的基线水平与AS组患者采用TNF-α抑制剂治疗后3个月其血清DKK-1和CTX-1水平未发生明显变化(P>0.05),血清骨钙蛋白水平明显升高(P<0.05),血清骨保护素水平和BASDAI评分降低(P<0.05)。结论 AS患者的血清DKK-1水平低于健康者,AS患者采用抗TNF-α治疗后尽管可改善其BASDAI评分,但血清DKK-1水平不会发生明显变化。更多还原

【Abstract】 Objective To compare the serum Dickkopf-1(DKK-1) level in patients with ankylosing spondylitis(AS) with that in healthy people and investigate the effects of tumor necrosis factor-α(TNF-α) blocking agents on the serum DKK-1 levels in patients with AS.Methods 56 AS patients(AS group) and 40 healthy people(control group) were enrolled in the study.The levels of DKK-1,osteocalcin,osteoprotegerin,and C-terminal telopeptide of type I collagen(CTX-1) were measured in AS group before and 3 months after the initiating of anti-TNF-α therapy.For AS patients,Bath Ankylosing Spondylitis Disease Activity Index(BASDAI) scores were also measured before and after anti-TNF-α therapy.Results Serum levels of DKK-1 were significantly lower in AS group than in the control group(P<0.05).Osteocalcin and osteoprotegerin levels were significantly higher in AS group than control group(P<0.05).Serum levels of DKK-1 and CTX-1 did not change after the 3-month anti-TNF-α therapy,while Osteocalcin level increased(P<0.05),and osteoprotegerin level and BASDAI scores decreased(P<0.05) significantly after the 3-months anti-TNF-α therapy.Conclusion Patients with AS have Lower serum DKK-1 levels compared with healthy people and the serum DKK-1 levels in patients with AS did not change after anti-TNF-αtherapy despite the significant improvement in BASDAI scores.Low serum DKK-1 level could be related with the pathogenesis of new bone formation in AS.更多还原