关节炎患者血清肿瘤坏死因子α的检测及意义

Determination of serum TNF-αin patients with arthritis its significance

目的 探讨类风湿关节炎 (RA)、强直性脊柱炎 (AS)和骨关节炎 (OA )患者血清肿瘤坏死因子α(TNF -α)的水平及临床意义。方法 应用双抗体夹心ELISA法测定RA、AS、OA和正常对照者的血清TNF -α并与炎性指标血沉 (ESR)和C反应蛋白 (CRP)作相关分析。结果 RA病人血清TNF -α水平明显高于正常对照组 (P <0 .0 0 1) ,血清TNF -α水平与炎性指标 (ESR和CRP)及类风湿因子滴度呈正相关。AS组和正常对照组血清TNF -α比较有显著性差异 (P <0 .0 0 5 ) ,但与炎性指标无相关性。OA组中有 5例血清TNF -α水平高于正常对照组 ,但是两组差异无统计学意义 ,OA组ESR和CRP正常。结论 TNF -α是关节疾病发生、发展的重要因素 ,在RA炎症反应中处于中心地位。

Objective To determine the serum level of TNF α in patients with arthritis and estimate the correlation between TNF α and inflammatory indices. Methods the serum level of TNF α was measured by sandwich ELISA in 59 patients with rheumatoid arthritis(RA), 14 with osteoarthritis(OA), 8 with ankylosing spondylitis(AS)and 20 healthy individual. Results The serum level of TNF α were significantly higher in patients with RA( P <0.001) and AS( p <0.005) than in controls. Elevated serum level of TNF α in RA were correlated with inflammatory indices (including ESR and CRP)and the tite of RF(the correlation coefficients r were 0.408,0.412 and 0.559,the correponding P Values<0.05,<0.05 and<0.001)The TNF α level of patients with AS was no significantly correlated with inflammatory indices. The TNF α level was not statistically different between OA patients and controls. Conclusion TNF α is a key agent of the pathogenesis of joint disease and may play a predominant role in the inflammatory reaction in RA.