类风湿关节炎血清白细胞介素17和肿瘤坏死因子α及滑膜病变检测的意义

Detection of interleukin-17 and tumor necrosis factor-alpha and synovium pathological changes in patients with rheumatoid arthritis and significance

目的探讨血清白细胞介素17（IL-17）和肿瘤坏死因子仪（TNF-α）及滑膜病变检测在类风湿关节炎（RA）患者中的临床意义。方法应用酶联免疫吸附测定法（EuSA）对50例活动期RA患者（活动期RA组）、50例稳定期RA患者（稳定期RA组）和50例体检健康者（健康对照组）血清IL-17和TNF-α水平进行检测，同时取其关节滑膜进行病理检查。结果活动期RA组血清IL-17和TNF-α水平[（42．60±11．30）、（113．20±13．11）mg/L]明显高于稳定期RA组[（19．60±5．75）、（14．50±5．33）mg／L]和健康对照组[（7．40±3．32）、（10．90±2．24）mg／L]（P〈0．01）；稳定期RA组血清IL-17水平高于健康对照组（P〈0．05），而TNF-α水平与健康对照组比较差异无统计学意义（P〉0．05）。RA患者的滑膜与健康对照组相比呈明显的病态。结论RA患者血清IL-17和TNF-α水平及滑膜病变的变化特点与病情有关，联合动态监测有助于临床观察和治疗。

Objective To investigate the levels of serum interleukin -17（IL-17） and tumor necrosis factor -alpha（TNF-α） and synovium pathological changes in patients with rheumatoid arthritis （RA） and its clinical significance. Methods The levels of serum IL-17 and TNF-α in 50 patients with active phase of RA （active phase of RA group） ,50 patients with stable phase of RA （stable phase of RA group） and 50 normal controls （NC group ） were measured by enzyme-linked immunospecific assay（ELISA ）, and the synovium was detected by pathological examination. Results The levels of serum IL-17 and TNF-α in active phase of RA group [ （42.60 ± 11.30）, （ 113.20 ± 13.11 ） mg/L ] were significantly higher than those in stable phase of RA group [ （ 19.60 ± 5.75）, （ 14.50 ±5.33 ） mg/L] and NC group [ （7.40 ± 3.32）, （ 10.90 ± 2.24） mg/L] （P 〈 0.01 ）, the level of serum IL-17 in stable phase of RA group was significantly higher than that in NC group （P 〈 0.05）, but the level of TNF-α had no significant difference between stable phase of RA group and NC group （P 〉 0.05 ）. The synovium was significantly different between RA patients and NC group. Conclusion IL-17 and TNF-α are more sensitive index for detecting the activity of RA and may play important roles in monitoring the therapeutic effects and prognosis of RA.