初诊类风湿关节炎患者外周血维生素D及其受体mRNA的水平和诊断意义

Levels and diagnostic significance of vitamin D and its receptor mRNA in peripheral blood of patients with first diagnosis of rheumatoid arthritis

目的观察初诊类风湿关节炎患者外周血维生素D及其受体mRNA的表达特征,并分析上述指标表达水平变化在疾病诊断中的意义。方法选择2016年2—10月东莞市人民医院健康管理中心收治的39例初诊类风湿关节炎患者作为观察组,同期选择42名健康体检者作为对照组。检测外周血维生素D及其受体mRNA的表达水平,并对比观察组中不同疼痛程度、不同肿胀关节数患者外周血维生素D及其受体mRNA的表达水平。结果观察组患者的外周血维生素D表达水平显著低于对照组受试者,受体mRNA的表达水平显著高于对照组受试者,差异有统计学意义(P<0.05)。轻度疼痛患者外周血维生素D水平显著高于中重度程度患者,重度疼痛患者受体mRNA的表达水平显著高于轻中度疼痛患者,差异有统计学意义(P<0.001)。肿胀关节数>5个的患者外周血维生素D水平显著低于肿胀关节数≤5个的患者,肿胀关节数>5个的患者受体mRNA的表达水平显著高于肿胀关节数≤5个的患者,差异有统计学意义(P<0.001)。结论外周血维生素D及其受体mRNA表达水平检测可用于初诊类风湿关节炎患者的疾病诊断和疾病进展评估。

Objective To observe the expression of vitamin D and its receptor mRNA in peripheral blood of patients with first diagnosis of rheumatoid arthritis（ RA）,and to analyze the significance of the changes of expression levels of these markers in the diagnosis of rheumatoid arthritis. Methods The levels of vitamin D and its receptor mRNA in peripheral blood of 39 newly diagnosed rheumatoid arthritis patients（ observation group）and 42 healthy subjects（ control group） were detected. The levels of vitamin D and its receptor mRNA in the observation group were compared,including the expression of vitamin D and its receptor mRNA in peripheral blood of patients.Results The expression level of vitamin D in the peripheral blood of the observation group was significantly lower than that of the control group,and the expression level of the receptor mRNA was significantly higher than that of the control group,the difference was statistically significant（ P〈0.05）. The level of vitamin D in peripheral blood of patients with mild pain was significantly higher than that of moderate and severe patients.The expression level of receptor mRNA in patients with severe pain was significantly higher than that in mild or moderate pain patients（ P〈0.001）.The expression of vitamin D in peripheral blood of patients with more than 5 swollen joints was lower than that of 5 patients（ P〈0. 05）,and the mRNA expression level of the receptor was higher than that of 5 patients,the difference was statistically significant（ P〈0.001）. Conclusions The detection of vitamin D and its receptor mRNA in peripheral blood can be used to diagnose disease and evaluate the progression of rheumatoid arthritis.