炎症相关细胞因子表达升高与类风湿关节炎病情程度的相关性分析

The application of inflammation-related cytokines in early diagnosis and disease assessment of rheumatoid arthritis

目的检测类风湿关节炎(RA)患者血清中细胞因子的含量,探讨炎性相关细胞因子联合检测对RA病情程度评估的临床应用价值。方法募集RA患者28例和同期15例健康体检者。多重微球流式免疫荧光发光法检测白细胞介素1β(IL-1β)、IL-2、IL-5、IL-6、IL-8、IL-12P70、IL-17、肿瘤坏死因子α(TNF-α)、α干扰素(IFN-α)、IFN-γ、IL-4、IL-10炎症相关细胞因子表达情况,全自动生化分析仪检测C反应蛋白(CRP),魏氏法测量红细胞沉降率(ESR),获取炎症指标数据。计算RA组患者28关节疾病活动指数(DAS28),比较各细胞因子与RA疾病活动度的曲线下面积,分析RA患者炎症相关细胞因子血清水平与CRP、ESR的相关性。结果RA患者血清中IL-2、IL-6、IL-12P70、IL-4、IL-10与RA疾病活动度的指标DAS28-CRP显著相关,IL-12P70、TNF-α、IL-4与RA疾病活动度的指标DAS28-ESR显著相关,反映RA患者病情程度的指标CRP与IL-6(r=0.515)、IL-12P70(r=0.530)、IL-4(r=0.539)、IL-10(r=0.434)呈正相关,ESR与IL-6(r=0.403)、IL-12P70(r=0.475)、TNF-α(r=0.497)、IL-4(r=0.450)呈正相关。与CRP、ESR正常组比较,CRP异常组中IL-6、IL-12P70、IL-2、IL-4、IL-10水平升高,ESR异常组中IL-12P70、IL-4、TNF-α水平升高。RA组患者IL-8、IFN-α、IFN-γ表达较健康组升高。结论血清中炎症相关细胞因子检测对RA的早期诊断和病情程度判断有重要的参考价值,可作为确诊RA的重要预测指标。

Objective To measure the serum contents of cytokines in patients with rheumatoid arthritis(RA)and explore the clinical application value of combined detection of inflammatory cytokines in evaluating the severity of RA.Methods This study recruited 28 RA patients and 15 healthy individuals who received health checkups during the same period.The expression of inflammatory cytokines including interleukin 1β(IL-1β),IL-2,IL-5,IL-6,IL-8,IL-12P70,IL-17,tumor necrosis factor-α(TNF-α),interferonα(IFN-α),IFN-γ,IL-4 and IL-10 were detected with the multiplexed microsphere-based flow cytometric immunoassay.C-reactive protein(CRP)was detected with an automatic biochemical instrument,and erythrocyte sedimentation rate(ESR)was measured by the Westergren method.The disease activity score in 28 joints(DAS28)in the RA group was calculated,and the area under the curve(AUC)of each cytokine and RA disease activity was compared.The correlation of serum levels of inflammatory cytokines with CRP and ESR was analyzed in RA patients.Results In RA patients,the serum levels of IL-2,IL-6,IL-12P70,IL-4 and IL-10 were significantly correlated with the indicator of RA disease activity DAS28-CRP,and the serum levels of IL-12P70,TNF-αand IL-4 were markedly correlated with the indicator of RA disease activity DAS28-ESR.CRP was positively correlated with IL-6(r=0.515),IL-12P70(r=0.530),IL-4(r=0.539),and IL-10(r=0.434).ESR was positively correlated with IL-6(r=0.403),IL-12P70(r=0.475),TNF-α(r=0.497),and IL-4(r=0.450).Compared with the normal CRP and ESR group,the abnormal CRP group showed an increase in the levels of IL-6,IL-12P70,IL-2,IL-4 and IL-10,and the abnormal ESR group exhibited an elevation in the levels of IL-12P70,IL-4 and TNF-α.The expression of IL-8,IFN-αand IFN-γwas higher in the experimental group than in the control group.Conclusion Serum inflammatory cytokines detection has shed light on the early diagnosis and severity evaluation of RA and can be used as a pivotal indcator for the diagnosis of RA.