类风湿性关节炎贫血患者血清TNFα,IFNγ和Epo的变化及意义

Changes of TNFα,IFNγ and Epo in Serum from Rheumatoid Arthritis Patients with Anemia and Their Significance

目的探讨肿瘤坏死因子α（ＴＮＦα）、干扰素γ（ＩＦＮγ）和促红细胞生成素（Ｅｐｏ）在类风湿性关节炎（ＲＡ）伴慢性疾病性贫血（ＡＣＤ）的发生机制中的作用。方法采用ＥＬＩＳＡ法检测ＲＡ患者血清中ＴＮＦα、ＩＦＮγ，及ＲＡ伴ＡＣＤ患者的Ｅｐｏ变化，并测定ＲＡ患者的铁代谢指标。结果与对照组比较，ＲＡ组及ＲＡ伴ＡＣＤ组血清中ＴＮＦα、ＩＦＮ－γ均显著增高。ＴＮＦα、ＩＦＮγ与血清铁、血红蛋白浓度呈负相关。ＲＡ伴ＡＣＤ者的Ｅｐｏ水平高于对照组，但低于同等贫血程度的单纯缺铁性贫血组。结论ＲＡ伴ＡＣＤ者体内Ｅｐｏ相对不足；ＴＮＦα、ＩＦＮγ介导ＲＡ的ＡＣＤ发病可能与影响铁代谢和Ｅｐｏ的生成等相关。

Objective\ To elucidate the role of tumor necrosis factor alpha(TNFα), interferon gamma(IFNγ) and erythropoietin(Epo) in the pathogenesis of the anemia of chronic disease (ACD). \ Methods\ Serum TNFα,IFNγ levels in all RA patients and serum Epo levels in RA with ACD were measured by ELISA. \ Serological parameters of iron status in all RA patients were detected.\ Results\ Serum TNFα,IFNγ levels in RA and RA with ACD patients were higher than those in normal controls. \ TNFα,IFN γ were inversely correlated with the hemoglobin, serum iron, respectively. Serum Epo levels in ACD were higher than those in normal controls,but lower than those in patients with iron deficieny anemia who had comparable hemoglobin level.\ Conclusion\ The relative Epo deficieny in RA with ACD. \ In the pathogenesis of RA with ACD TNFα and IFNγ possibly act through impairing iron metabolism and inhibiting Epo production。