Spondyioarthritis Features And Level Change And Correlation Studies Of Serum IL-6,TNF-?,14-3-3 Eta Protein In Patients With Spondyloarthritis

ObjectiveTo explore prevalence and reference value of Spondyioarthritis features in patients with spondyloarthritis and change and Correlation Studies of serum levels of IL-6,TNF-?,14-3-3 eta protein before and after therapy in Spondyioarthritis patientsMethodsSpondyioarthritis features and laboratory indexes and radiographic indexes of 505 patients with spondyloarthritis(SpA)including 353 patients of ankylosing spondylitis(AS),62 patients of non-radiographic axial spondyloarthritis(nr-axSpA)and 90 patients of peripheral spondyloarthritis(pSpA)were recorded in detail.AS disease activity index(BASDAI,ASDAScrp),laboratory inflammatory index(ESR,CRP)and Bath ankylosing spondylitis function index(BASFI)were also calculated in the meantime MRI of the sacroiliac joints(MRI-SI)and radiograph of sacroiliac joints(X-SI)and lumbar vertebra were measured to calculate Spondloarthritis research consortium of Canada(SPARCC)and scores of sacroiliac joints and modified Stoke ankylosing spondylitis spine score(mSASSS).Serum levels of IL-6,TNF-?,14-3-3 Eta Protein in 42 SpA patients before and after therapy were measured by Enzyme-Linked Immunosorbent Assay.One-way analysis of variance,Nonparametric test,dependent sample t test,?2-test,logistic regressive,spearman correlation analysis were used for statistical analysisResultsSex ratio(?2=20.673,P<0.0001),age(?2=22.258,P<0.0001),disease duration(?2=76.052,P<0.0001)were different among AS,nr-axSpA and pSpA.Besides,BASDAI,ASDAScrp,ESR,CRP and BASFI were different among SpA subgroups(?2/F=13.196?40.028,[<0.05).Prevalence of inflammatory back pain,peripheral arthritis,preceding infection,positive HLA-B27 and elevated CRP were different among SpA subgroups(?2=11.416?32.657,P<0.0001-0.002).Prevalence of dactylitis in SpA with positive HLA-B27 was lower than that in SpA with negative HLA-B27(?2=5.414,P=0.02).Prevalences of enthesitis and dactylitis in SpA patients with peripheral arthritis were higher than that in SpA without peripheral arthritis involvement(?2=7.177?14.428,P<0.0001-0.007).Prevalence of good response to NSAIDs in patients with anterior uveitis involvement was higher than SpA without anterior uveitis involvement(?2=4.578,P=0.032).SpA patients were stratified for total number of SpA features into 4 subgroups(n?1,n=2,n=3,n>4).Prevalence of inflammatory back pain,positive HLA-B27,elevated CRP were the top three in all subgroups.Inflammatory back pain and HLA-B27(+)were risk factors for axSpA(OR=3.254-3.323,P<0.0001-0.001).Peripheral arthritis,dactylitis,and preceding infection were risk factors for pSpA(OR=3.759?17.044,P<0.0001-0.01).Compared to pre-treatment,BASDAI?SPARCC?ASDAScrp?PGA?ESR?CRP,BASFI decreased post-therapy(Z=-3.545?2.646,P<0.0001-0.046)and the serum levels of TNF-? and 14-3-3 eta protein decreased(Z=-2.158?-1.685,P=0.015-0.047)too.The serum levels of IL-6 didn't changed significantly(Z=-0.25,P=0.407),however the change of IL-6 were correlated with ASDAScrp and CRP(r=0.492-0.505,P=0.006-0.008).Conclusion Inflammatory back pain,HLA-B27(+)and elevated CRP should be emphasized for diagnosis of SpA.Inflammatory back pain and HLA-B27(+)always suggest axSpA Peripheral arthritis,dactylitis and preceding infection always suggest pSpA.After treatment,the serum levels of TNF-? and 14-3-3 eta protein decreased.The serum levels of TNF-? and 14-3-3 eta protein were decreased after treatment in SpA patients and change of serum levels of IL-6 reflect the disease activity of SpA.