血浆骨桥蛋白在类风湿关节炎中的研究

Study of plasma osteopontin in patients with rheumatoid arthritis.

目的探讨血浆骨桥蛋白（OPN）在类风湿关节炎（RA）中的表达及意义。方法RA患者共65例，其中活动组37例，缓解组28例。正常对照组22例，来自本院健康体检者。RA临床评价核心指标采用ARA推荐的RA疾病活动性评价核心指标，摄RA患者手部正位X片，采用ARA的RAX线分期标准，同时记录患者有无关节外损害。应用ELISA测定血浆OPN水平。结果RA患者血浆OPN水平显著高于正常对照组[（3．29±2．06）、（1．42±0．94）ng／L，P〈0．01]；RA活动组血浆OPN水平显著高于缓解组[（3．98±2．28）、（2．37±1．27）ng／L，P〈0．01]，且和疾病活动性相关（P〈0．05）；不同X线分期的RA患者血浆OPN水平具有差异，分期越高，其水平越高[Ⅰ期23例，OPN（1．83±0．89）ng／L；Ⅱ期11例，OPN（2．64±0．99）rig／L；Ⅲ期17例，OPN（3．75±1．47）ng／L；Ⅳ期14例，OPN（5．63±2．43）ng／L，P均〈0．05]；RA患者血浆OPN水平有关节外损害患者高于无关节外损害者[（4．53±3．17）、（2．91±1．43）ng／L，P〈0．05]。结论OPN在RA发病过程中起一定作用，可作为RA病情活动的监测指标之一，其可能参与RA的骨破坏及关节外损害。

Objective To explore the plasma osteopontin （OPN） levels and its clinical significance in rheumatoid arthritis （RA）. Methods 65 patients with RA were enrolled in the study,of which there were 37 active cases,28 cases were of remission,and all the patients met the American Rheumatism Association （ARA）. The core indexes of clinical evaluation of RA were recommended by ARA. The hands X-ray of RA patients were taken and RA X-ray phase standards recommended by ARA were used. 22 normal controls were all from the health examinations in our hospital. The levels of OPN were detected with enzyme-linked immunosorbent assay （ELISA）. Results The levels of plasma OPN in RA patients were significantly higher than that in the healthy controls [ （ 3.29 ± 2.06） vs （1.42 ±0.94）ng/L, P 〈 0.01 ]. The levels of plasma OPN in RA patients with activities were significantly higher than that in RA remission group[ （3.98 ±2.29） vs （2.37 ± 1.27） ,P 〈0.01 ] ,and had correlation with disease activity（P 〈0.05）. The serum OPN levels in RA patients at different X-ray stages were significantly different, which was higher when the staging was higher[23 cases in stage Ⅰ（ 1.83 ±0.29）ng/L;ll cases in stage Ⅱ（2.64 ±0.09） ng/L;17 cases in stage Ⅲ （3.75 ±1.17 ）ng/L;and 14 cases in stage Ⅳ （5.63 ± 2.43 ）ng/L,P 〈 0.05 for each ]. The plasma OPN levels in RA patients with out of joints damages were significantly higher than that without out of joints damages[ （4.53 ±3.17） vs （2.91 ±1.43）ng/L] （P〈0.05）. Conclusion OPN plays an important role in the pathogenesis of RA. It can be good indicators of the degree of the general activity of RA,and it may be invovled in the joint destruction and out of joint damages in RA.