类风湿关节炎患者疾病活动期和缓解期血清瘦素水平变化的意义

Serum leptin levels in patients with active and non-active rheumatoid arthritis and their significance

目的了解瘦素(Leptin)在类风湿性关节炎(RA)患者血清中的变化规律。方法用DAS28评分方法判断RA病情活动性,检测96例类风湿性关节炎患者(活动期47例,缓解期49例)及40名健康对照者血清中瘦素、TNF-α、IL-1β、IL-6、RF、CRP、ESR、抗-CCP水平,分析瘦素与这些指标间的相关性。结果 RA活动期患者血清瘦素、TNF-α、IL-1β、IL-6、RF、CRP、ESR、抗-CCP水平均明显高于健康对照组和RA缓解组(P<0.01),其中女性瘦素水平又显著高于男性(P<0.05);RA缓解期组以上指标与健康对照组无统计学差异(P>0.05);RA活动期组血清瘦素与TNF-α、IL-1β、IL-6、RF、CRP、ESR、抗-CCP水平、DAS28呈显著正相关(P<0.05)。结论 RA患者血清瘦素水平与病情活动性具有密切关系,可能作为一种协同炎性因子促进RA病情的进展。

Objective To study the changing rules of serum leptin levels in patients with rheumatoid arthritis（RA）. Methods Activity of RA was assayed according to the 28-joint count disease activity score（DAS28）. Serum levels of leptin, TNF-α, IL-1β, IL-6, RF, CRP, ESR and anti-CCP were measured in 40 healthy controls and 96 patients including 47 patients with active RA and 49 patients with non-active RA. Correlation between leptin and TNF- α, IL-1β, IL-6, RF, CRP, ESR and anti-CCP was analyzed. Results The serum levels of leptin, TNF- α, IL-1β, IL-6, R.F, CRP, ESR and anti-CCP were significantly higher in patients with active RA than in healthy controls（P〈0.01） and the serum level of leptin was significantly higher in women than in men（P〈0.05）. No significant difference was observed in serum levels of leptin, TNF- α, IL-1β, IL-6, RF, CRP, ESR and anti-CCP between patients with non-active RA and healthy controls. The serum level of leptin was significantly related with those of TNF-α, IL-1β, IL-6, RF, CRP, ESR and anti-CCP in patients with active RA（P〈0.05）. Conclusion Serum leptin level in RA patients is closely related the activity of RA, and leptin can act as a cofactor in promoting the progression of RA.