钙防卫蛋白与痛风及其并发症形成的相关性研究

    Clinical study of calprotectin in gout and its complications

    • 摘要: 目的 研究钙防卫蛋白在痛风及其并发症形成中的作用。方法 选取痛风性关节炎患者49例,其中痛风急性发作期24例,缓解期25例,健康志愿者40例,采用ELISA检测血清中钙防卫蛋白水平,比较痛风组患者与健康对照组患者、痛风急性发作期与缓解期患者钙防卫蛋白水平差异,并分析痛风患者钙防卫蛋白水平与血肌酐及尿素氮水平的相关性,同时进一步分析有无肾结石及有无脂肪肝的痛风患者血清钙防卫蛋白水平变化。结果 (1)与健康对照组相比,痛风组患者钙防卫蛋白浓度显著上升7075.6(5095.5,9316.8) ng/mL比2831.2(2124.8,3334.8) ng/mL,P<0.01,且痛风患者组中,痛风缓解组钙防卫蛋白水平明显低于急性发作组患者6497.2(4174.4,8447.2) ng/mL比8403.4(6082.2,11515.6) ng/mL,P=0.007。(2)痛风患者组血肌酐水平明显高于健康对照组(85.39±15.21 μmol/L比70.86±12.85 μmol/L,P=0.025),尿素氮水平两组之间虽差异无统计学意义,但痛风组患者尿素氮水平显示出上升趋势(5.45±1.52mmol/L比4.47±1.12 mmol/L,P=0.075)。(3)痛风患者血清中钙防卫蛋白水平与血肌酐水平呈正相关(r=0.396,P=0.012),与尿素氮水平无显著相关性(r=-0.150,P=0.363)。(4)在痛风组患者中,合并肾结石患者与未合并肾结石组患者中钙防卫蛋白浓度差异无统计学意义5873.6(3191.2,10712.0) ng/mL比7095.4(5171.6,9357.2) ng/mL,P=0.524,而合并脂肪肝患者的钙防卫蛋白浓度显著高于未合并脂肪肝患者11515.6(6497.2,13320.4) ng/mL比5873.6(3191.2,10712.0) ng/mL,P=0.002。结论 钙防卫蛋白可能参与了痛风的发病,且对于痛风急性发作有一定的判断作用,而在痛风的相关并发症中,钙防卫蛋白可能与急性肾损伤及脂肪肝的形成有关,而与肾结石的形成无关。

       

      Abstract: Objective To explore the role of calprotectin in gout and its complications. Methods A total of 49 patients with gouty arthritis were selected,including 24 patients with acute attack of gout,25 patients with remission of gout and 40 healthy controls. Serum calprotectin levels were detected by enzyme-linked immunosorbent assay(ELISA). The differences of calprotectin levels were compared between healthy control,patients with acute gout attack and remission. And the correlations were examined between calprotectin level and serum levels of creatinine and urea nitrogen in gout patients. Concurrently,the changes of serum calprotectin level in gout patients with or without kidney stones and fatty liver were further analyzed. Results As compared with control group,the level of calprotectin spiked markedly in gout group7075.6(5095.59316.8) vs 2831.2(2124.83334.8),P<0.01and the level of calprotectin was significantly lower in remission group than that in acute attack group. The serum creatinine level was significantly higher in gout than that in control group(85.39±15.21 vs 70.86±12.85,P=0.025). Although no significant inter-group difference existed in urea nitrogen level,urea nitrogen level showed a rising trend in gout group(5.45±1.52 vs 4.47±1.12,P=0.075). Serum calprotectin level was positively correlated with serum creatinine level(r=0.396,P=0.012),but not with urea nitrogen level(r=-0.150,P=0.363). In gout group,no significant difference existed in calprotectin concentration between patients with and without kidney stones5873.6(3191.210712.0) vs 7095.4(5171.69357.2),P=0.524while calprotectin level was significantly higher in patients with fatty liver than that in those without fatty liver11515.6(6497.213320.4) vs 5873.6(3191.2,10712.0),P=0.002. Conclusion Involved probably in the pathogenesis of gout,calprotectin has a certain predictive effect on acute attack of gout. As for the complications of gout,calprotectin may be correlated with the formation of acute kidney injury and fatty liver. However,its role in the formation of kidney stones should be further explored.

       

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