探讨体内微量元素铜与活动性类风湿关节炎的关系

Correlation between the body copper level and active rheumatoid arthritis

目的探讨体内微量元素铜与活动性类风湿关节炎（RA）的关系。方法试验组：72例活动性RA患者，予以双重滤过血浆置换2—3次，两次之间间隔1周。对照组：健康志愿者50名，其中IO名予以双重滤过血浆置换．各1次。试验组根据首次双重滤过血浆置换血浆滤出液的颜色分为试验1组：血浆滤出液呈墨绿色；试验2组：血浆滤出液呈绿色和黄绿色。应用电喷雾质谱法、红外光谱法、电感耦合等离子体质谱法分析试验组血浆滤出液中与绿色物质相关的成分（结论表明绿色相关成分为铜的化合物）。应用电感耦合高频等离子体发射光谱法定量分析试验组和对照组血清铜含量及首次血浆滤出液铜含量。比较试验组和对照组血清铜含量及首次血浆滤出液铜含量；比较两试验组铜含量与疾病活动指数的关系。比较试验组和对照组血浆滤出液的颜色。结果①试验组首次血浆滤出液铜、血清铜含量分别为（3．61±1．12）mg／L，（2．46±0．75）mg／L，明显高于对照组[（1.51±0．21）mg／L，（0．72±0．19）mg／L]（P〈0．01）。试验1组疾病活动指数、铜含量分别为39±8，（3．9±0．9）mg／L，明显高于试验2组[26±6，（2．6±0．4）mg／L]（P〈0．01）。②试验组血浆滤出液呈绿色，对照组血浆滤出液呈黄色。③血浆滤出液中绿色物质为铜的化合物。结论体内微量元素铜的升高与RA的活动性密切相关。

Objective To investigate the relationship between body copper level and active rheumatoid arthritis. Metheds In 72 patients with active rheumatoid arthritis （the test group）, double filtration plasmapheresis （DFPP） was performed once a week for 2-3 sessions. Of 50 healthy individuals selected as the control group, 10 underwent a single DFPP. According to the color of plasma filtrate from the first session of DFPP, the test-group was further divided as the test-group 1, where the plasma filtrate was dark green, and the test-group 2, where plasma filtrate was green or yellow-green. Green-related material of plasma filtrate in test-group was determined by ESI-MS, IR and ICP-MS techniques. The copper levds in the first-DFPP plasma filtrate and serum samples were determined by ICP-AES and compared between test groups and control group. In addition, the copper levels were compared between the two test subgroups in correlation with disease activity indexes. Difference in color of plasma filtrate in the test-group and controlgroup was also discussed. Results ① Of statistical significance, the levels in first-DFPP plasma filtrate and serum samples were （3.61±1.12） mg/L and （2.46±0.75） mg/L in the test-group vs （1.51±0.21） mg/L and （0.72±0.19） mg/L in the control-group （P〈0.01）. The disease activity index and serum copper level were 39±8 and （3.9±0.9） mg/L in the test group 1 vs 26±6 and （2.6±0.4） mg/L in the test group 2 （P〈0.01）. ② The color of plasma filtrate was green in the test-group compared with yellow in the control-group. ③ The green-related material in plasma filtrate proved to be a compound of copper. Conclusion The increase in serum copper level is significantly correlated with rheumatoid arthritis activity.