Abstract：
To detect the value of serum interleukin-17 (IL-17), tumour necrosis factor-α (TNF-α), and Dickkopf-1 (DKK-1) in rheumatoid arthritis (RA) at different disease stages. 141 RA patients were randomly obtained and diagnosed in a large tertiary first-class hospital in Jiangxi Province from November 2021 to January 2022. RA was divided into 38 low activity and remission phase (low remission patients), 72 moderate activity patients, 41 high activity patients, according to the disease activity score 28 (DAS28) of RA and 70 healthy controls. IL-17 and TNF-α in serum detected by flow cytometry; DKK-1by ELISA; rheumatoid factor (RF) and C-reactive protein (CRP) by rate scattering turbidimetry; erythrocyte sedimentation rate (ESR) by Widmanstat method; anti-cyclic citrullinated polypeptide antibody (Anti-CCP) by chemiluminescence. The changes among the groups were statistically analysed and evaluated their diagnostic value. ①Anti-CCP, CRP, and ESR levels in the moderate-to-high activity group were higher than controls, while IL-17, TNF-α, and DKK-1levels higher than low remission group, moderate activity group and controls (p < 0.05). ②IL-17, TNF-α and DKK-1 were positively correlated with RA disease activity, with the correlations of IL-17, TNF-α and DKK-1 all over 0.5 (p < 0.05). ③The ROC curve showed that among all indices the AUC of DKK-1 was the largest, 0. 922, and has the highest sensitivity and negative predictive value for RA, 0.965 and 0.953, respectively. The specificity and positive predictive value of TNF-α is highest, 0.918 and 0.921, respectively, combined them had the highest predictive value in moderate-to-high activity RA, with AUC of 0.968, and had the highest sensitivity of 0.965. The IL-17, TNF-α and DKK-1 levels were elevated in RA and positively correlated with disease activity, involved in the Wnt signalling pathway of inflammatory and joint destructive effects, combining them to monitor the RA disease process and biologically treat the cytokines in the pathogenesis of RA were valuable.
摘要：
检测血清白细胞介素-17(IL-17)的价值,肿瘤坏死因子-α（TNF-α），和Dickkopf-1（DKK-1）在不同疾病阶段的类风湿关节炎（RA）中的作用。选取2021年11月至2022年1月在江西省某大型三级甲等医院随机诊断的RA患者141例。RA分为38例低活动期和缓解期（低缓解期），72名中度活动患者，41名高活性患者，根据RA和70名健康对照的疾病活动评分28(DAS28)。流式细胞术检测血清中IL-17和TNF-α;ELISA法检测DKK-1;速率散射比浊法检测类风湿因子(RF)和C反应蛋白(CRP);Widmanstat法检测红细胞沉降率(ESR);化学发光法检测抗环瓜氨酸多肽抗体(Anti-CCP)。对各组间的变化进行统计学分析并评价其诊断价值。①反CCP,CRP,中高活性组的ESR水平高于对照组，而IL-17、TNF-α、DKK-1水平高于低缓解组,中度活动组和对照组(p<0.05)。②IL-17、TNF-α、DKK-1与RA病情活动度呈正相关,IL-17、TNF-α和DKK-1的相关性均超过0.5(p<0.05)。③ROC曲线显示，在所有指标中，DKK-1的AUC最大，0.922，对RA的敏感性和阴性预测值最高，分别为0.965和0.953。TNF-α的特异性和阳性预测值最高,分别为0.918和0.921，它们在中高活性RA中的预测价值最高，AUC为0.968，灵敏度最高为0.965。IL-17、TNF-α和DKK-1水平在RA中升高,且与疾病活动度呈正相关,参与炎症和关节破坏作用的Wnt信号通路，将它们结合起来监测RA的疾病过程，并对RA的发病机制中的细胞因子进行生物学治疗是有价值的。
