【摘要】 目的 探讨骨膜蛋白（POSTN）与类风湿关节炎（RA）患者疾病活动度的相关性。方法 回顾性分析佛山市第一人民医院风湿免疫科2019年1月-2022年1月收治的114例类风湿关节炎患者，依据DAS28评分将患者分为疾病活动组72例和疾病稳定组42例，同期纳入在本院体检中心体检健康者60名作为健康对照组。比较三组患者的一般临床资料，外周血和关节滑膜组织中POSTN蛋白水平，分析POSTN蛋白与类风湿关节炎患者疾病活动度的相关性，并进一步采用logistic回归模型分析疾病活动期的可能危险因素。结果 类风湿关节炎患者的血清POSTN蛋白与类风湿因子（r=0.232,P=0.013）、C反应蛋白（r=0.321,P<0.05）、病程（r=0.338,P<0.05）、DAS28评分（r=0.673,P<0.05）呈显著相关性。类风湿关节炎患者的外周血POSTN蛋白水平显著高于健康对照组，疾病活动组患者外周血的POSTN蛋白水平（7.6±1.4）ng/mL高于疾病稳定组（5.6±1.6）ng/mL和健康对照组（3.2±1.6）ng/mL，差异有统计学意义（F=134.203,P<0.05），且疾病活动组滑膜组织中POSTN蛋白表达高于疾病稳定组患者[（1.0±0.1）ng/mL vs.(0.6±0.1)ng/mL]，差异有统计学意义（P<0.05）。类风湿关节炎患者的外周血POSTN蛋白水平（RR=2.024,95%CI:1.311～3.126）是判断RA疾病活动度的独立危险因素。结论 POSTN蛋白和RA患者的疾病活动度呈显著相关性，可作为独立危险因素预测RA患者的疾病活动度。更多还原

【Abstract】 Objective To detect periostin(POSTN)levels in peripheral blood and synovial tissue of patients with differentdisease activity in rheumatoid arthritis(RA).Methods A retrospective analysis of 114 rheumatoid arthritis patientsadmitted to the Department of Rheumatology and Immunology of Foshan First People ’ s Hospital from January 2019 toJanuary 2022 was conducted. According to the DAS28 score,the patients were divided into a disease active group of 72cases and a disease stable group of 42 cases. During the same period,60 healthy people who underwent physicalexamination in the physical examination center of our hospital were included as the healthy control group. The general clinicaldata of the three groups of patients,the levels of POSTN protein in peripheral blood and joint synovial tissue were compared,and the correlation between POSTN protein and disease activity in patients with rheumatoid arthritis was analyzed,and thepossible risk of disease activity was further analyzed by logistic regression model.Results Serum POSTN protein andrheumatoid factor(r=0.232,P=0.013),C-reactive protein(r=0.321,P<0.05),course of disease(r=0.338,P<0.05),DAS28 score(r=0.673,P<0.05)showed a significant correlation. The peripheral blood POSTN protein level of rheumatoidarthritis patients was significantly higher than that of the healthy control group,and the peripheral blood POSTN proteinlevel of the disease active group(7.6±1.4)ng/m L was higher than that of the stable disease group(5.6±1.6)ng/m L and the healthy control group(3.2±1.6)ng/m L;the differences were statistically significant(F=134.203,P<0.05). The expression of POSTN protein in the synovial tissue of the active disease group was higher than that of the stable disease group[(1.0±0.1)ng/m L vs.(0.6±0.1)ng/m L]. The difference was statistically significant(P<0.05). The peripheral blood POSTN protein level in patients with rheumatoid arthritis(RR=2.024,95%CI:1.311-3.126)was an independent risk factor for judging the disease activity of RA.ConclusionPeriostin was significantly correlated with the disease activity of rheumatoid arthritis patients,which could be used as an independent risk factor to predict the disease activity of rheumatoid arthritis.更多还原