Abstract:Objective: To study the changes of levels of serum mannose-binding lectin (MBL), MBL-associated serine protease-2 (MASP-2) and Dickkopf-1 protein (DKK-1) in patients with rheumatoid arthritis (RA) and their correlation with prognosis of patients. Methods: 194 RA patients and 102 health examiners in our hospital from August 2017 to August 2020 were selected as the study group and the control group. Serum MBL, masp-2 and DKK-1 levels were detected at admission. According to 28 joint disease activity scores (DAS28), the patients were divided into mild group (n = 83), moderate group (n = 62) and severe group (n = 49). According to the guidelines, RA patients were given standard treatment. According to the efficacy, the patients were divided into standard group (n = 129) and standard group (n = 65), The serum levels of MBL, masp-2 and DKK-1 were compared in each group, and their influence on DAS28 score and predictive value for curative effect were analyzed. Results: The levels of serum MBL and MASP-2 in study group were lower than those in control group, while the level of serum DKK-1 was higher than that in control group. The levels of serum MBL and MASP-2 in mild, moderate and severe groups were gradually decreased, while the level of serum DKK-1 and DAS28 score were gradually increased. The levels of serum MBL and MASP-2 in standard group were higher than those in non-standard group, while the level of serum DKK-1 was lower than that in non-standard group (P<0.05). Multivariate linear regression analysis showed that the levels of serum MBL and MASP-2 were important factors affecting the DAS28 score (P<0.05). Serum MBL and MASP-2 levels were closely related to the treatment effect of RA, and logistics regression model of substandard RA treatment was shown as Y=12.573-0.722× serum MBL-0.090× serum MASP-2+0.792× serum DKK-1. The AUC values of serum MBL, MASP-2, DKK-1 and the combined detection of the three in predicting the efficacy of RA were 0.896, 0.825, 0.693 and 0.958 respectively, and the sensitivities were 72.09%, 67.44%, 80.62% and 89.15%, and the specificities were 90.77%, 81.54%, 52.31% and 90.77%. Conclusion: The levels of MBL and masp-2 in serum of RA patients were significantly decreased, while the level of DKK-1 in serum was significantly increased, which was closely related to the changes of the disease, and could provide reference information for the evaluation of curative effect and prognosis.
臧雪莲, 鞠延玲, 赵旭. 类风湿性关节炎患者血清MBL MASP-2和DKK-1水平变化与患者预后相关性[J]. 河北医学, 2021, 27(7): 1070-1075.
ZANG Xuelian, JU Yanling, ZHAO Xu. Changes of Serum MBL Masp-2 and DKK-1 Levels in Patients with Rheumatoid Arthritis and Their Correlation with Prognosis. HeBei Med, 2021, 27(7): 1070-1075.