检验医学与临床2024，Vol.21Issue(2)：161-165,5.DOI:10.3969/j.issn.1672-9455.2024.02.004
25(OH)D、D-D和FDP对类风湿关节炎活动度的鉴别诊断价值
The value of 25(OH)D,D-D and FDP in the differentiation of rheumatoid arthritis activity
摘要
Abstract
Objective To investigate the diagnostic value of 25-hydroxyvitamin D[25(OH)D],D-dimer(D-D)and fibrin degradation products(FDP)in the differential diagnosis of rheumatoid arthritis(RA)activi-ty.Methods A total of 101 patients with active RA in Qinghai Provincial People's Hospital from September 2022 to February 2023 were selected as RA activity group(RAA group),79 patients with RA in remission were selected as RA remission group(RAR group),and 90 patients with other autoimmune diseases during the same period were selected as OA group,and 90 healthy subjects were selected as HC group.The levels of 25(OH)D,D-D,FDP,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and rheumatoid factor(RF)in fasting peripheral blood were detected.Spearman correlation was used to evaluate D-D,FDP,anti-cy-clic citrullinated antibody,ESR,RF,CRP,DAS28 scores and 25(OH)D levels.The receiver operating charac-teristic(ROC)curve was used to evaluate the differential diagnostic value of each index alone and combined detection for RA activity.Results The levels of 25(OH)D,D-D and FDP in RAA group were significantly different from those in RAR group,OA group and HC group(P＜0.05).The 25(OH)D level in RAR group was significantly different from that in HC group(P＜0.05).There were significant differences in D-D and FDP levels between the OA group and the HC group(P＜0.05),and the 25(OH)D was negatively correla-ted with the 7 indexes(P＜0.05),but the correlation was weak.ROC curve analysis showed that when the best cut-off value of 25(OH)D was 16.41 U/mL,the AUC was 0.708,the sensitivity was 82.2％,and the specificity was 60.8％.When the optimal cut-off value of D-D was 1.90 U/mL,the AUC was 0.670,the sensi-tivity was 90.1％,and the specificity was 46.8％.When the optimal cut-off value of FDP was 6.10 U/mL,the AUC was 0.665,the sensitivity was 88.1％,and the specificity was 44.3％.The AUC of the combined detec-tion of ESR,CRP,D-D,FDP and 25(OH)D was 0.959.Conclusion The serum levels of 25(OH)D,FDP and D-D have certain value in the differential diagnosis of RA disease activity,and the differential diagnostic value of ESR,CRP,D-D,FDP and 25(OH)D is higher.关键词
类风湿关节炎/25羟基维生素D/二聚体/纤维蛋白降解产物/疾病活动度Key words
rheumatoid arthritis/25-hydroxyvitamin D/D-dimer/fibrin degradation products/dis-ease activity分类
医药卫生引用本文复制引用
马继登,吕艳锞,李子安,阿祥仁,周健武,曹春花,周丹,程鹏,杨博杰..25(OH)D、D-D和FDP对类风湿关节炎活动度的鉴别诊断价值[J].检验医学与临床,2024,21(2):161-165,5.基金项目
青海省卫生健康系统重点课题(2021-wjzdx-25) （2021-wjzdx-25）
青海省"昆仑英才·高端创新创业人才"计划[青人才字(2021)13号]. （2021）
