类风湿性关节炎患者血清CD_(40)L及IL-6 hs-CRP表达及临床意义

The Clinical effect of T-cell CD40 ligand,IL-6 and hs-CRP expression on rheumatoid arthritis patients

目的探讨类风湿性关节炎(RA)患者血清白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)和T细胞CD40配体(CD40L)水平变化及其临床意义。方法 90例RA患者为观察组(又分RA活动组、RA稳定组),90例健康志愿者为对照组。采用增强免疫比浊测量法检测患者血清中hs-CRP水平,以酶联免疫吸附法检测CD40L、IL-6水平。结果 RA组患者外周血清血小板计数(BPC)、类风湿因子(RF)、红细胞沉降率(ESR)、hs-CRP、IL-6及CD40L均明显高于对照组,差异均具有统计学意义(P<0.05);除RF外,RA活动组患者外周血清中BPC、ESR、hs-CRP、IL-6及CD40L均明显高于RA稳定组患者,差异均具有统计学意义(P<0.05)。血小板升高组RA患者外周血清中RF、ESR、hs-CRP、IL-6及CD40L均明显高于血小板正常组的RA患者,差异均具有统计学意义(t=6.070、3.858、3.272、3.217、2.253,P<0.05)。结论血清hs-CRP、IL-6及CD40L与RA炎症反应关系密切,联合检测可临床观察RA患者的病情变化和治疗效果,具有一定临床应用价值。

Objective To investigate clinical significance and the variation of serum interleukin -6（IL-6） ,high-sensitivity C-reac-tive protein（hs-CRP） and T-cell CD40 ligand（CD40 L） in patients with rheumatoid arthritis （RA）（included activity group and stable group） .Methods 90 cases of RA patients in the observation group ,90 cases of healthy volunteers were selected as control group . Enhanced immunoturbidimetric assay was used in measurement of serum hs-CRP .Levels of CD40 L ,IL-6 were detected by enzyme-linked immunosorbent assay .Results BPC ,RF ,ESR ,hs-CRP ,IL-6 and CD40 L in peripheral serum of observation group were sig-nificantly higher than control group ,the differences were statistically significant （P〈0 .05） .BPC ,ESR ,hs-CRP ,IL-6 and CD40 L in peripheral blood of patients in RA activity group were significantly higher than patients with RA in stable group ,the differences were statistically significant（P〈0 .05） .RF ,ESR ,hs-CRP ,IL-6 and CD40L in peripheral serum of RA patients whose platelet ele-vated were significantly higher than RA patients whose platelet stay normal level ,the differences were statistically significant （t=6 . 070 ,3 .858 ,3 .272 ,3 .217 ,2 .253 ,P〈0 .05） .Conclusion Serum hs-CRP ,IL-6 and CD40 L relate to RA inflammation closely .Com-bined detection can observe the condition changes and treatment effect in patients with RA .