类风湿关节炎血管内皮生长因子趋化因子RANTES的研究

Study of vascular endothelial growth factor chemokine RANTES in patients with rheumatoid arthritis

目的探讨血管内皮生长因子(VEGF)、调节活化和正常T细胞表达及分泌的趋化因子(RANTES)在类风湿关节炎(RA)发病中的作用,在疾病活动性判断、鉴别诊断中的价值,以及二者是否在RA发病中具有协同作用。方法用酶联免疫吸附试验(ELISA)法测定36例RA患者、20例骨关节炎(OA)患者及20名健康体检人员血清中VEGF和RANTES水平。结果①活动期RA患者血清中VEGF、RANTES水平显著高于缓解期RA组、OA组(P<0.05)及健康对照组(P<0.01),缓解期RA患者血清中VEGF亦显著高于健康对照组(P<0.05),而与OA组相比差异无显著性(P>0.05)。缓解期RA患者血清RANTES水平与OA组及健康对照组之间差异均无显著性(P>0.05)。②RA患者血清VEGF与RANTES之间具有相关性(P<0.05)。结论①活动期RA患者血清VEGF、RANTES水平高于RA缓解期,提示VEGF、RANTES可作为RA活动期判断指标之一。②活动期RA患者血清中VEGF、RANTES水平升高,高于OA组,有助于二者之间的鉴别诊断。③活动期RA患者血清中VEGF、RANTES呈正相关关系,提示VEGF、RANTES在RA的发生、发展中具有相辅相承、互相促进作用。

Objective To explore the value of vascular endothelial growth factor (VEGF) and RANTES in the diagnosis,differential diagnosis of rheumatoid arthritis (RA),in order to clarify whether they are synergetic in the pathogenesis of RA.Method VEGF and RANTES in serum were quantified by the enzyme linked immunosorbent assay in 36 RA patients, 20 osteoarthritis (OA) patients, and 20 healthy controls. Results ①Serum level of VEGF and RANTES of RA active patients was higher than clinically remissive RA patients (P<0.05),OA patients (P<0.05) and healthy controls (P<0.01).② There was a close correlation between VEGF and RANTES in active patients with RA (P<0.05).Conclusions ① The serum level of VEGF and RANTES in patients with active RA is significantly higher than that in patients with clinical remission RA,which shows that VEGF,RANTES can serve as one of the indicative index of active RA.② The serum level of VEGF,RANTES in active RA is higher than that in patients with OA.They are useful in the differential diagnosis between them. ③ The level of VEGF,correlates with that of RANTES in the serum of active RA patients.This indicates that VEGF and RANTES play interdependant roles in the onset and development of RA.