摘要
目的探讨类风湿性关节炎(rheumatoid arthritis,RA)患者血清、关节液白介素-35(interleukin-35,IL-35)水平变化及其与疾病的相关性。方法选取2013年3月至2015年12月间门诊及住院部诊治的RA发病初期患者74例、RA快速发展期患者98例以及骨关节炎(Osteoarthritis,OA)患者58例为研究对象。采用酶联免疫吸附法(ELISA)测定研究对象的血清和关节液中IL-35水平,免疫比浊法测定血清C反应蛋白(CRP)水平。RA患者的疾病程度通过28个关节活动指数(28-Joint Count Disease Activity Score,DAS28)进行评估。结果与OA患者比较,RA发病初期与RA快速发展期患者实验开始时血清IL-35水平显著升高(P均<0.01),但应用抗风湿药物治疗12周后,两期患者IL-35水平均下降(P均<0.01)。与OA患者比较,RA快速发展期患者关节液IL-35水平明显升高,且高于三组患者各时点的血清IL-35水平,差异均有统计学意义(P均<0.01);治疗12周后降低,接近OA患者关节液IL-35水平。快速发展期RA患者中,关节液IL-35水平与CRP水平(r=0.327,P<0.05)及DAS28值(r=0.425,P<0.05)分别呈现中等相关。结论血清IL-35水平在RA发病初期和快速发展期均升高,且随治疗控制而下降;RA快速发展期关节液IL-35水平与炎症指标和疾病活动度指标相关;提示血清、关节液中的IL-35在RA疾病的进展和控制中发挥着重要作用。
Objectives To study the association of changes of interleukin-35 （ IL-35 ） levels in serum and synovial fluid with the state of illness in patients with rheumatoid arthritis （RA）. Methods A total of 172 patients with RA including 74 cases at the early stage of the onset and 98 cases at rapid development stage and 58 patients with osteoarthritis （OA）di- agnosed and treated in outpatient and inpatient department between March 2013 and December 2015 were selected as re- search objects. Enzyme linked immunosorbent assay （ELISA） method was used to detect IL-35 levels in serum and synovial fluid. Immunoturbidimetry was used to detect level of serum C-reactive protein. The 28-Joint Count Disease Activity Score （DAS28） was used to assess the disease severity of RA patients. Results Compared with OA patients, serum IL-35 levels in RA patients at the early stage of the onset and at rapid development stage increased significantly （ all P 〈 0.01 ）, but their levels decreased after therapy of antirheumatic drugs for 12 weeks （ all P 〈 0.01 ）. IL-35 level in synovial fluid of RA patients at rapid development stage significantly increased compared with OA patients （ P 〈 0.01 ） and was significantly higher than those in serum levels at each time points in three groups, but it decreased to near the level in synovial fluid of OA patient after treatment for 12 weeks. IL-35 level in synovial fluid in RA patients at rapid development stage was mode- rately correlated with CRP level （ r = 0.327, P 〈 0.05 ） and DAS28 value （ r = 0.425, P 〈 0.05 ）, respectively. Conclusions Serum IL-351evels increase at the early stage of the onset and at rapid development period, and decrease with disease control after therapy. IL-35 level in synovial fluid at rapid development stage is associated with inflammatory marker and disease activity index. Therefore, IL-35 in serum and synovial fluid play an important role in the progression and control of disease in RA patients.
出处
《中国临床研究》
CAS
2017年第4期463-466,共4页
Chinese Journal of Clinical Research
