类风湿关节炎患者的细胞因子谱变化及预测价值分析

Analysis of cytokine profile changes and predictive value in patients with rheumatoid

目的:通过对类风湿关节炎(RA)患者疾病活动时血清中多种细胞因子的检测,筛选出快速判断RA患者的指标及危险因素。方法:选取就诊于吉林省人民医院的RA患者35例和健康对照组40例,利用双抗体夹心流式荧光发光法检测外周血血清中白细胞介素(IL)-2、IL-4、肿瘤坏死因子-α(TNF-α)、IL-10、IL-17A、IL-6、干扰素(IFN)-γ、IFN-α、IL-5、IL-8、IL-12p70和IL-1β水平。同时比较两组并发基础疾病(如高尿酸血症、高血压、糖尿病、脑血管疾病等)的差异并进行相关性分析。结果:RA患者血清IL-2、IL-4、IL-10、IL-6、IL-8、IL-1β表达水平与健康对照组相比差异有统计学意义(P<0.05),并且IL-2、IL-4、IL-10、IL-6、IL-8、IL-1β与RA发病呈正相关,差异有统计学意义(P<0.05)。在并发症中,骨质疏松与RA发病呈正相关,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析显示IL-2、IL-4、IL-10、IL-6和IL-8的曲线下面积(AUC)分别为0.750 7、0.660 0、0.650 4、0.875 7、0.701 8和0.731 4。结论:血清中IL-2、IL-4、IL-10、IL-6、IL-8、IL-1β水平可以作为快速鉴别RA的指标,为今后RA的诊治提供新依据,并且合并骨质疏松人群更易患RA。

Objective To screen the indicators and risk factors for rapid determination of rheumatoid arthritis(RA)patients through the detection of various cytokines in the serum of RA patients at the time of disease activity.Method Thirty-five patients with rheumatoid arthritis and 40 healthy people attending the Jilin Provincial People's Hospital were selected,and IL-2,IL-4,TNF-α,IL-10,IL-17A,IL-6,IFN-γ,IFN-α,IL-5,IL-8,IL-12p70,and IL-1βlevels were detected in the peripheral serum of patients with RA at the time of disease activity by using a double-antibody sandwich flow-through fluorescence luminescence assay.Differences in concurrent underlying diseases such as hyperuricemia,hypertension,diabetes mellitus,and cerebrovascular diseases between the two groups were also compared and analyzed for correlation.Results The elevated levels of serum IL-2,IL-4,IL-10,IL-6,IL-8 and IL-1βin RA patients were significantly different from those in healthy controls(P<0.05),and IL-2,IL-4,IL-10,IL-6,IL-8,IL-1βwere positively correlated with the development of RA(P<0.05).Among the complications,osteoporosis was positively correlated with the onset of RA(P<0.05).ROC curve analysis showed that the AUC areas of IL-2,IL-4,IL-10,IL-6,and IL-8 were 0.7507,0.6600,0.6504,0.8757,0.7018,and 0.7314,respectively.Conclusion IL-2,IL-4,IL-10,IL-6,IL-8,and IL-1βserum levels can be used as indicators for rapid identification of rheumatoid arthritis,providing a new basis for future RA diagnosis and treatment.People suffering from rheumatoid arthritis are more likely to be combined with osteoporosis.