不同时期类风湿关节炎患者血清炎性因子的变化及临床意义

Changes and clinical significance of serum inflammatory factors in patients with rheumatoid arthritis at different stages

目的探讨不同时期类风湿关节炎(RA)患者血清炎症因子的变化及临床意义。方法 90例RA患者根据RA患者病情评价(DAS28)分为活动组(46例)和缓解组(44例),同时抽取体检正常患者50例为对照组,所有受试者抽取空腹外周静脉血5 ml分离血清,采用双抗体夹心酶联免疫吸附法(ELISA)检测肿瘤坏死因子(TNF)-α、血管内皮生长因子(VEGF)、白细胞介素(IL)-1β、IL-6、IL-8、IL-10表达,同时观察常规检测指标,分析血清炎症因子表达变化及临床意义。结果 3组血清TNF-α、VEGF、IL-1β、IL-6、IL-8、IL-10水平组间比较差异有统计学意义(P<0.05),其中活动组均高于对照组(P<0.05),缓解组TNF-α、IL-6、IL-8、IL-10水平高于对照组(P<0.05)。TNF-α、VEGF、IL-1β、IL-6、IL-8、IL-10血清炎症因子分别与晨僵时间、关节肿胀指数、压痛指数、C反应蛋白(CRP)、红细胞沉降率(ESR)、DAS28存在正相关关系(P<0.05)。结论 RA病情可能与血清炎症因子介导的免疫反应密切相关,监测血清炎症因子在评估RA病情严重程度和预后及治疗效果评价中具有重要临床价值。

Objective To investigate the changes and clinical significance of serum inflammatory factors in patients with rheumatoid arthritis （RA） at different stages. Methods 90 patients with RA were divided into active group （n=46） and remission group （n=44） according to the disease evaluation （DAS28） of RA patients with;at the same time ,50 normal patients were selected as control group. The expressions of tumor necrosis factor （TNF）-α, vascular endothelial growth factor （VEGF）, interleukin （IL）-1β and IL-6, IL-8, IL-10 were detected by double antibody sandwich enzyme-linked immunosorbent assay （ELISA）. Results There were significant differences in serum TNF-α, VEGF, IL-1β, IL-6, IL-8 and IL-10 levels among the 3 groups （ P〈0.05 ）, the levels of TNF-α, VEGF, IL-1β, IL-6, IL-8, IL-10 in active group were higher than those in control group（ P〈0. 05） ,the levels of TNF-α,IL-6, IL-8 and IL-10 in remission group were higher than those in control group（ P〈0.05 ）. The levels of TNF-α, VEGF, IL-1β, IL-6, IL-8, and IL-10 were positively correlated with the time of morning stiffness, swelling index, joint tenderness index, CRP, ESR, DAS28 （P〈0.05）. Conclusions RA patient＇s conditions might be closely related to the immune reaction by serum inflammatory factors mediation, and it has great clinical value to monitor the serum inflammatory factors in evaluating the severity and prognosis and treatment effect of RA.