类风湿性关节炎患者血清GM-CSF,IL-6,TNF-α水平的变化及其临床意义

Changes and Clinical Significance of Serum GM-CSF,IL-6 and TNF-α Levels in Patients with Rheumatoid Arthritis

目的:通过检测类风湿性关节炎(RA)患者血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平,探讨其用于RA诊断与预后判断的临床意义。方法:选取我院2013年6月~2016年12月收治的126例RA患者为RA组,并根据病情严重程度分为活动期RA组(69例)和缓解期RA组(57例)两个亚组;另选取同期于我院体检中心接受体检的55例健康体检者为对照组。采用酶联免疫吸附法(ELISA)检测所有对象的血清GM-CSF、IL-6、TNF-α水平。记录比较各组血清细胞因子水平,并分析RA组患者各细胞因子水平及DAS28间的相关性。结果:活动期RA组的血清GM-CSF、IL-6、TNF-α水平均显著高于缓解期RA组和对照组(P<0.01),缓解期RA组的血清GM-CSF、IL-6、TNF-α水平亦均显著高于对照组(P<0.01)。血清GM-CSF、IL-6及TNF-α水平三者间均呈显著正相关(P<0.01);DAS28与血清GM-CSF、IL-6、TNF-α水平亦均呈显著正相关(r=0.473、0.584、0.675,P均<0.01)。结论:类风湿性关节炎患者的血清GM-CSF、IL-6、TNF-α水平均显著上调,且与类风湿性关节炎的活动性呈显著正相关,通过检测此类细胞因子对类风湿性关节炎的早期诊断、病情评估及判断预后均具有重要临床意义。

Objective：To investigate the changes and clinical significances of serum levels of granulocyte macrophage colony-stimulating factor（GM-CSF）,interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） levels in patients with rheumatoid arthritis（RA）.Methods：126 cases of patients with RA in our hospital from June 2013 to December 2016 were selected as RA group and divided into two subgroups as active RA group（69 cases） and remission RA group（57 cases） according to the severity of the disease.55 healthy cases who receive physical check in our hospital at same time were selected as the control group.The serum GM-CSF,IL-6 TNF-α levels were detected by enzyme linked immunosorbent assay（ELISA） and compared between different groups,the correlation of serum GM-CSF,IL-6 TNF-α levels with DAS28 were analyzed.Results：The serum GM-CSF,IL-6 TNF-α levels of RA group were significantly higher than those of the remission RA group and control group（P〈0.01）,and the serum GM-CSF,IL-6 TNF-α levels of remission RA group were also significantly higher than those of the control group（P〈0.01）.Positive correlation between serum GM-CSF,IL-6 and TNF-α levels were found（P〈.0.01）.The level of DAS28 was significantly correlated with the levels of serum GM-CSF,IL-6 and TNF-α（r=0.473,0.584,0.675,all P〈0.01）.Conclusion：The levels of serum GM-CSF,IL-6 and TNF-α were up-regulated in patients with RA and positively correlated with the activity of RA,which might be of important clinical significance in the early diagnosis,disease evaluation and prognosis of RA.