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目的:检测强直性脊柱炎(AS)患者血清中可溶性CD137(sCD137)的表达水平并探讨其在强直性脊柱炎发病中的意义。方法:选择AS患者57例,健康体检者30例作为正常对照组,用ELISA检测AS患者、健康体检者血清sCD137水平,同时测定AS患者的红细胞沉降率(ESR)、C反应蛋白(CRP)、人类白细胞抗原B27(HLA-B27)。用统计学分析各组血清中sCD137的变化及其与相关临床指标的相关性。结果:初治组患者血清sCD137水平显著高于正常组及治疗组(P<0.05),治疗组患者血清sCD137水平与正常对照组无显著性差异(P>0.05)。按骶髂关节CT结果进行分组:Ⅰ、Ⅱ级AS患者血清sCD137水平高于正常对照组(P<0.05),Ⅲ级AS患者血清sCD137水平与正常对照无显著差异。按Bath强直性脊柱炎活动指数(BASDAI)进行评价分组,活动组患者血清sCD137水平显著高于正常对照组(P<0.05),静止组患者血清sCD137水平与正常对照组无显著性差异。HLA-B27阳性患者与HLA-B27阴性患者血清sCD137表达水平无显著差异。AS患者血清sCD137与ESR、CRP呈正相关(P<0.05)。AS患者年龄及性别与患者血清sCD137无明显相关性。结论:AS患者血清中sCD137的水平显著升高,提示sCD137在AS患者病情活动判定上具有一定的意义,可能参与了AS发病过程。
Objective: To detect the expression of soluble CD137 (sCD137) in serum of patients with ankylosing spondylitis (AS) and to explore its significance in the pathogenesis of ankylosing spondylitis. Methods: Fifty-seven AS patients and 30 healthy volunteers were selected as normal control group. Serum levels of sCD137 in AS patients and healthy subjects were detected by ELISA. Serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) Human leukocyte antigen B27 (HLA-B27). Using statistical analysis of serum sCD137 changes in each group and its correlation with clinical indicators. Results: The serum sCD137 level in the newly diagnosed group was significantly higher than that in the normal group and the treated group (P <0.05). The serum sCD137 level in the untreated group was not significantly different from that in the normal control group (P> 0.05). According to the result of sacroiliac joint CT, the level of serum sCD137 in grade I and grade II AS patients was higher than that in normal control group (P <0.05). The level of serum sCD137 in grade III AS patients was not significantly different from that of normal controls. According to Bath Ankylosing Spondylitis Activity Index (BASDAI), the level of serum sCD137 in active group was significantly higher than that in normal control group (P <0.05). There was no significant difference in serum sCD137 between inactive group and normal control group. Serum sCD137 expression levels in HLA-B27-positive patients and HLA-B27-negative patients were not significantly different. Serum sCD137 in patients with AS was positively correlated with ESR and CRP (P <0.05). There was no significant correlation between age and sex of AS patients and serum sCD137 in patients. Conclusion: Serum levels of sCD137 in patients with AS are significantly elevated, suggesting that sCD137 may play a role in determining the severity of AS and may be involved in the pathogenesis of AS.