【摘要】 目的 探讨亚临床期关节病型银屑病(PsA)患者血清中CXCL10表达水平，分析血清中CXCL10表达水平在诊断亚临床期PsA的临床价值。方法 选择2023年1月—2025年6月皖南医学院第一附属医院皮肤科收治的120例寻常型银屑病患者作为研究对象，根据是否合并亚临床期PsA,分为单纯性银屑病组(79例)和亚临床期PsA组(41例),同时纳入同期60名健康体检者作为对照组。收集寻常型银屑病患者的临床指标，所有研究对象血清中CXCL10表达水平采用ELISA法检测。Pearson法分析寻常型银屑病CXCL10与PASI评分的相关性，采用Logistic回归分析探讨寻常型银屑病合并亚临床期PsA的独立危险因素，采用受试者工作特征曲线(ROC)分析血清CXCL10对寻常型银屑病合并亚临床期PsA的诊断价值。结果 对照组、单纯性银屑病组和亚临床期PsA组血清中CXCL10表达水平分别为(32.12±4.45)mmol/L、(49.09±6.47)mmol/L和(63.29±7.22)mmol/L,呈现显著升高趋势，任何两组间比较具有显著差异(F=43.269,P<0.001)。120例寻常型银屑病患者血清中CXCL10表达水平为(58.35±6.94)mmol/L,PASI评分为(19.09±5.78)分，血清中CXCL10表达水平与PASI评分具有显著正相关性(r=0.573,P=0.021)。性别、年龄、家族史、吸烟史、饮酒史、共患糖尿病比例、共患高血压比例、共患血脂异常比例在单纯性银屑病组和亚临床期PsA组中相比差异无统计学意义(P>0.05);与单纯性银屑病组相比，BMI、银屑病病程、PASI评分、hs-CRP、IL-6、ESR、WBC和N在亚临床期PsA组中显著升高，差异具有统计学意义(P<0.05)。Logistic回归分析结果显示，BMI(OR=2.555)、PASI评分(OR=1.846)和CXCL10(OR=3.421)是寻常型银屑病合并亚临床期PsA的独立危险因素。ROC曲线结果显示血清中CXCL10表达水平在诊断寻常型银屑病合并亚临床期PsA曲线下面积为0.956,CXCL10最佳截断值为56.17 mmol/L,诊断敏感度和特异度分别为91.05%和92.55%。结论 寻常型银屑病合并亚临床期PsA患者血清中CXCL10表达水平显著升高，CXCL10高表达是寻常银屑病合并亚临床期PsA的危险因素，且CXCL10可作为评估亚临床期PsA的一项生物学标志物。更多还原

【Abstract】 Objective Texplore the serum expression level of CXCL10 in patients with subclinical psoriatic arthritis(PsA) and analyze its clinical value in diagnosing subclinical PsA.Methods From January 2023 to June 2025, 120 patients with psoriasis vulgaris admitted to the Department of Dermatology at the First Affiliated Hospital of Wannan Medical College were enrolled. Based on the presence of subclinical PsA, they were divided into a psoriasis-only group(n=79) and a subclinical PsA group(n=41), with an additional 60 healthy volunteers as the control group. Clinical indicators of psoriasis vulgaris patients were collected, and serum CXCL10 levels were measured using ELISA. Pearson correlation analysis was used to assess the relationship between CXCL10 and PASI scores, while logistic regression analysis identified independent risk factors for subclinical PsA in psoriasis vulgaris. The diagnostic value of serum CXCL10 was evaluated using the receiver operating characteristic(ROC) curve.Results The serum expression levels of CXCL10 in the control group, psoriasis-only group and subclinical PsA group were(32.12±4.45) mmol/L,(49.09±6.47) mmol/L and(63.29±7.22) mmol/L respectively, showing a significant increasing trend. There was a significant difference between any two groups(F=43.269, P<0.001). The serum expression level of CXCL10 of 120 patients with psoriasis vulgaris was(58.35±6.94) mmol/L, and the PASI score was(19.09±5.78). The serum expression level of CXCL10 was significantly positively correlated with the PASI score(r=0.573, P=0.021). There were no significant differences in gender, age, family history, smoking history, drinking history, proportion of comorbidities with diabetes, proportion of comorbidities with hypertension, and proportion of comorbidities with dyslipidemia between the psoriasis-only group and the subclinical PsA group(P>0.05). Compared with the psoriasis-only group, the BMI, psoriasis duration, PASI score, hs-CRP, IL-6, ESR, WBC and N were significantly increased in the subclinical PsA group, and the differences were statistically significant(P<0.05). The Logistic regression analysis showed that BMI(OR=2.555), PASI score(OR=1.846), and CXCL10(OR=3.421) were independent risk factors for psoriasis vulgaris combined with subclinical PsA. The ROC curve results showed that the AUC of serum CXCL10 expression level in the diagnosis of psoriasis vulgaris combined with subclinical PsA was 0.956, the optimal cut-off value of CXCL10 was 56.17 mmol/L, and the diagnostic sensitivity and specificity were 91.05% and 92.55%, respectively.Conclusions The expression level of CXCL10 in the serum of patients with psoriasis vulgaris combined with subclinical PsA is significantly increased. The high expression of CXCL10 is a risk factor for psoriasis vulgaris combined with subclinical PsA, and the CXCL10 can be used as a biomarker for evaluating subclinical PsA in psoriasis vulgaris patients.更多还原