目的：探讨血清可溶性内皮细胞蛋白C受体(sEPCR)在类风湿关节(RA)患者中的表达及临床意义。方法：选取2022年8月至2023年5月包医一附属风湿免疫科收治的80例RA患者为RA组,以及同时期80例健康者作为对照(HC)组。记录并整理所有纳入人员的基本信息,以及RA患者的实验室检查指标和DAS28评分。通过酶联免疫吸附法(ELISA)测定两个分组血清sEPCR水平。比较RA组与HC组血清sEPCR水平差异;观察不同疾病活动度间血清sEPCR的表达水平;Spearman法分析血清sEPCR水平与RA患者临床及实验室指标之间的相关性,并利用ROC分析其临床诊断价值。结果：相较于HC组,RA组的血清sEPCR水平显著升高(P＜0.000 1)。相关性分析显示:RA患者中EPCR水平与年龄、红细胞沉降率(ESR)、C-反应蛋白(CRP)及疾病活动评分(DAS28评分)均呈现正相关(P＜0.001)。利用ROC分析,结果显示AUC为0.901 7,以血清sEPCR水平＜0.693 2 ng/mL为作为诊断临界值,其敏感性为81.01%,特异性为88.31%。结论：血清sEPCR水平与RA疾病活动度密切相关,同时血清sEPCR水平对RA具有一定的诊断价值。
Objective: To investigate the expression and clinical significance of serum soluble endothelial protein C receptor (sEPCR) in patients with rheumatoid arthritis (RA). Methods: From August 2022 to May 2023,80 RA patients were admitted to Department of Rheumatology and Immunology,the First Affiliated Hospital of Baotou Medical College,along with 80 healthy individuals as the control (HC) group during the same period. Basic information of all participants,as well as laboratory examination indicators and Disease Activity Score in 28 joints (DAS28) scores of RA patients,were recorded and organized. The levels of serum sEPCR in both groups were measured using enzyme-linked immunosorbent assay (ELISA). The serum sEPCR levels were compared between HC and RA groups,as well as the levels among different disease activities. Spearman analysis was employed to explore the correlation between serum sEPCR levels and clinical and laboratory indicators in RA patients. ROC analysis was performed to assess its clinical diagnostic value. Results: The serum sEPCR levels were significantly increased in the RA group compared to the HC group (P＜0.000 1). Correlation analysis showed that sEPCR levels were positively correlated with age,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),and DAS28 score (P＜0.001). ROC analysis revealed an area under the curve (AUC) of 0.901 7,with a serum sEPCR level less than 0.693 2 ng/mL as the diagnostic cutoff value,demonstrating a sensitivity of 81.01% and specificity of 88.31%. Conclusion: Serum sEPCR levels are closely related to the disease activity of RA,and have a certain diagnostic value for RA.
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