类风湿性关节炎患者肿瘤坏死因子α和鞘磷脂酶的检测及临床意义

Detection of tumor necrosis factor-alpha and sphingomyelinase in patients with rheumatoid arthritis and its clinical significance

目的探讨鞘磷脂酶(sMase)和肿瘤坏死因子α(TNF-α)在类风湿性关节炎(RA)患者发生动脉粥样硬化(AS)中的临床意义。方法用TNF-α刺激培养的人脐带静脉血管内皮细胞(EC),检测上清液中sMase活性。对124例RA患者[单纯RA组66例、RA合并冠心病(CHD)组58例]和相应对照组检测血清sMase活性、TNF-α浓度水平。结果经TNF-α刺激后EC的sMase活性显著升高;RA组患者血清sMase活性高于对照组,尤其是RA合并CHD组;单纯RA组和RA合并CHD组患者血清TNF-α活性高于对照组。结论 TNF-α刺激EC sMase活性增加。RA患者TNF-α和sMase活性增高与血管内皮损伤有关,sMase有可能成为血管内皮功能障碍(ECD)的实验室诊断指标之一。

Objective To investigate the clinical significance of sphingomyelinase（sMase）and tumor necrosis factor-alpha（TNF-α）in patients with rheumatoid arthritis（RA）and atherosclerosis（AS）.Methods The cultured human umbilical cord vein vascular endothelial cells（EC）were stimulated by TNF-α,and the activity of sMase in the supernatant was detected.The serum sMase activity and TNF-α levels were detected in 124 RA patients [66 patients with only RA and 58 RA patients also with coronary heart disease（CHD）] and the corresponding control group.Results The sMase activity of EC increased significantly after the stimulation of TNF-α.The serum sMase activity of RA group was higher than that of control group,especially the activity of RA combined CHD group was the highest.The serum TNF-α levels of only RA group and RA combined CHD group were higher than that of control group.Conclusions The sMase activity of EC increases with the stimulation of TNF-α.The increases of TNF-α level and sMase activity in RA patients are related to vascular endothelial damage.Therefore,sMase activity may become one of the laboratory diagnostic indicators of vascular endothelial cell dysfunction（ECD）.