类风湿关节炎患者外周血miR-146a、miR-16的表达水平及临床指标与中医证型的关系探讨

A study of the relationships between expressions of miR-146a,miR-16,clinical data and traditional Chinese medicine syndrome types of rheumatoid arthritis

目的研究类风湿关节炎(RA)患者外周血miR-146a、miR-16的表达及ESR、CRP、RF、抗CCP抗体与中医证型的关系,为RA辨证分型提供客观依据。方法根据《中药新药临床研究指导原则》有关RA的中医证候诊断标准,主要分为两个证型:风湿夹瘀型(n=20)和肝肾亏损型(n=16);16名健康体检者作为健康对照组。Real-timePCR检测RA患者及健康对照组miR-146a、miR-16的表达,记录ESR、CRP、RF、抗CCP抗体等临床指标。结果风湿夹瘀型miR-146a、miR-16的表达水平高于肝肾亏损型和对照组(P均<0.05),肝肾亏损型miR-146a、miR-16的表达水平与健康对照组相比差异无统计学意义(P均>0.05),风湿夹瘀型RA患者ESR及CRP高于肝肾亏损型(P<0.01和P<0.05),RF低于肝肾亏损型(P<0.05),抗CCP抗体在两种证型之间差异无统计学意义(P>0.05)。结论 miR-146a、miR-16的表达水平和ESR、CRP、RF等临床指标可能为RA风湿夹瘀及肝肾亏损型的辨证分型提供参考。

Objective To investigate the relationships between the expressions of miR-146a,miR-16,clinical data and traditional Chinese medicine（TCM） syndrome types of rheumatoid arthritis and provide reference for syndrome differentiation.Methods Based on guiding principles for the clinical study of Chinese Medicines and clinical experience to formulate the syndrome diagnostic criteria,subjects were divided into two type of syndromes：syndrome of wind-dampness combined with blood stasis（n=20）,syndrome of impair of liver and kidney（n=16）.16 healthy controls were included for the study.The expression levels of miR-146a and miR-16 were measured using real-time polymerase chain reaction（RT-PCR）.Clinical data were collected.Results The expression levels of miR-146a and miR-16 in syndrome of wind-dampness combined with blood stasis RA patients were higher than those in syndrome of impair of liver RA patients and healthy control（P〈0.05）.The expression levels of miR-146a and miR-16 were not significant different between syndrome of impair of liver RA patients and healthy control（P〈0.05）.ESR and CRP in syndrome of wind-dampness combined with blood stasis RA patients were higher than those in syndrome of impair of liver and kidney RA patients,whereas RF was lower than that in syndrome of impair of liver and kidney RA patients（P〈0.05）.The level of anti-CCP antibody was not significant different between the two syndrome types（P〈0.05）.Conclusion The levels of miR-146a and miR-16,ESR,CRP and RF in patients with syndrome of wind-dampness combined with blood stasis and patients with syndrome of impair of liver and kidney are significantly different,which suggest that these indicators may act as reference for syndrome differentiation.