类风湿关节炎患者血清炎性因子、ANCA水平与血管内皮损伤标志物的相关性分析

Correlation of Vascular Endothelial Injury with Inflammatory Mediators and ANCA in Rheumatoid Arthritis Patients

目的:探讨类风湿关节炎(RA)患者血清炎性因子及抗中性粒细胞胞浆抗体(ANCA)水平与血管内皮损伤的相关性。方法:106例RA患者,分为活动组(83例)和缓解组(23例),55例健康人群作为对照,采用ELISA检测各组血清炎性因子白介素-1β(IL-1β)、白介素-6(IL-6)、白介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)及血管内皮损伤标志物-血管性血友病因子(vWF)、可溶性细胞间黏附分子-1(sI-CAM-1)及血管内皮黏附分子-1(sVCAM-1)水平;采用间接免疫荧光法(IIF)检测各组血清ANCA阳性率。比较各组上述指标水平差异,分析两组RA患者炎性因子水平、ANCA阳性率与血管内皮损伤标志物水平的相关性。结果:RA活动组IL-6、TNF-α、vWF、sICAM-1、sVCAM-1血清水平均高于对照组(P<0.05);RA缓解组IL-6、vWF水平均低于RA活动组(P<0.05),但vWF、sVCAM-1水平仍显著高于对照组(P<0.01);RA患者IL-6、IL-1β、IL-17与血管内皮损伤标志物有不同程度的相关性;RA患者活动组ANCA阳性率为32.5%,显著高于对照组(P<0.01);ANCA阳性患者vWF水平高于ANCA阴性患者(P<0.05)。结论:RA活动期患者存在较明显血管内皮损伤,这种损伤与高水平的炎性因子及ANCA阳性表达有关。

Objective:To investigate the correlation of vascular endothelial injury with inflammatory mediators and anti-neutrophil cytoplasmic antibody(ANCA) in rheumatoid arthritis(RA) patients.Method:The serum of 106 RA(including 83 active patients and 23 remissive patients)and 55 normal persons were collected.The concentrations of inflammatory mediators IL-1β,IL-6,IL-17,TNF-α and the biomarkers of vascular endothelial injury vWF,sICAM-1,sVCAM-1 were detected with enzyme-linked immunosorbent assay.ANCA was detected with indirect immunofluorescence.The differences between the RA patients and the controls were analyzed.The correlation of the inflammatory mediators,ANCA with vascular endothelial injury was evaluated.Results:IL-6,TNF-α,vWF,sICAM-1 and sVCAM-1 were higher in patients with active RA than those in the controls(P<0.05);IL-6 and vWF of the remissive RA patients were lower than those of the active patients(P<0.05),but vWF and sVCAM-1 were still higher than those of the normal controls(P<0.01).In RA patients,IL-6,IL-1β and IL-17 were correlated with the biomarkers of vascular endothelial injury.The positive rate of ANCA in the active RA patients(32.5%) was higher than in the normal controls(P<0.01).vWF was higher in the ANCA-positive RA patients than that in the ANCA-negative group(P<0.05).Conclusion:RA patients,especially the active RA patients had vascular endothelial injury,which was correlated with the level of inflammatory mediators and the positive rate of ANCA.