血小板、TNF-α及IL-1β与活动期类风湿关节炎的相关性研究

王志中; 王勇; 牟方祥; 方勇飞; 陈军; 罗彦; 石颖; 成娴; 吴红; 蒋毅

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血小板、TNF-α及IL-1β与活动期类风湿关节炎的相关性研究

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- 血小板、TNF-α及IL-1β与活动期类风湿关节炎的相关性研究
- Relationship between blood platelet, tumor necrosis factor-α, and interleukin-1β levels and activity of rheumatoid arthritis
- 陆军军医大学学报 2011年33卷第5期页码：469-472
- 作者机构：
  
  1. 第三军医大学：西南医院中西医结合科，预防医学院卫生统计学教研室
  2. 解放军69048部队卫生队
- 作者简介：
- 基金信息：
- DOI：
  中图分类号： R331.143;R392.11;R593.22
- 纸质出版日期：2011，
  
  网络出版日期：2011-03-15，
- 稿件说明：
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王志中, 王勇, 牟方祥, 等. 血小板、TNF-α及IL-1β与活动期类风湿关节炎的相关性研究[J]. 陆军军医大学学报, 2011,33(5):469-472.

WANG ZHIZHONG, WANG YONG, MU FANGXIANG, et al. Relationship between blood platelet, tumor necrosis factor-α, and interleukin-1β levels and activity of rheumatoid arthritis. [J]. Journal of army medical university, 2011, 33(5): 469-472.
王志中, 王勇, 牟方祥, 等. 血小板、TNF-α及IL-1β与活动期类风湿关节炎的相关性研究[J]. 陆军军医大学学报, 2011,33(5):469-472. DOI：

WANG ZHIZHONG, WANG YONG, MU FANGXIANG, et al. Relationship between blood platelet, tumor necrosis factor-α, and interleukin-1β levels and activity of rheumatoid arthritis. [J]. Journal of army medical university, 2011, 33(5): 469-472. DOI：

摘要

目的探讨类风湿关节炎(rheumatoid arthritis

RA)患者的疾病活动性与炎症相关因子的关系。方法收集363例住院和门诊RA患者的血清及临床数据，包括血沉(ESR)、C反应蛋白(CRP)、血小板计数(PLT)及类风湿因子(RF)，ELISA检测抗环瓜氨酸肽抗体(CCP)、葡萄糖6磷酸异构酶(GPI)、肿瘤坏死因子-α(TNF-α)及白细胞介素-1β(IL-1β)的表达，按DAS28(ESR)分为疾病高活动及中低活动组，分析PLT、TNF-α及IL-1β在RA疾病高、中低活动组与正常对照组之间的差异，探讨其与临床各指标的相关性。结果 RA疾病高活动组PLT水平明显高于中低活动与正常对照组(

=0.000)。3组间TNF-α、IL-1β计量值分布有显著差异（

0.05）。根据平均秩次推断，RA疾病高活动组TNF-α、IL-1β中位数分别为[2.97(1.87

13.53)、0.95(0.55

5.47)

]

pg/ml，中低活动组中位数分别为[2.78(1.91

8.18)、0.72(0.57

5.14)

]

pg/ml，均显著高于正常对照组（

0.01），而高活动组与中低活动组之间TNF-α或IL-1β比较计量值分布无统计学差异。PLT与关节压痛数、关节肿胀数、晨僵、VAS、DAS28(4)、CRP及ESR均呈显著正相关（

0.01），而TNF-α 与关节压痛数、VAS、DAS28(4)及ESR呈正相关（

0.05），IL-1β仅与ESR相关（

=0.179

=0.001）。PLT、TNF-α及IL-1β均与CCP、RF、GPI无相关性（

>0.05）。结论 PLT及TNF-α可作为RA疾病活动度的灵敏指标之一，IL-1β在一定程度上反应炎症活动程度。

Abstract

Objective To investigate the correlation between disease activity and the levels of inflammatory factors including blood platelet

tumor necrosis factor-α

(TNF-α)

and interleukin-1β (IL-1β) in rheumatoid arthritis (RA) patients. Methods Laboratory indexes including erythrocyte sedimentation rate (ESR)

C-reactive protein (CRP) level

platelet count (PLT)

and rheumatoid factor (RF) level of 363 RA patients were collected by conventional method. The expression of anti-cyclic citrullinated peptides (anti-CCP)

glucose-6-phosphate isomerase (GPI)

TNF-α

and IL-1β in serum was determined by ELISA. The RA patients were divided into high-disease activity group and moderate/low-disease activity group according to their DAS28 (4) ESR scores. The differences between the two groups and a control group in terms of PLT

TNF-α and IL-1β were analyzed to explore the correlation between disease activity and clinical indexes. Results The PLT in the high-disease activity group was significantly higher than those in the moderate/low-disease activity group and control group (

=0.000). There were significant differences among the three groups in terms of TNF-α and IL-1β level distributions (

0.05). According to mean rank order

the medians of TNF-α and IL-1β levels were [2.97 (1.87

13.53)

]

pg/ml and [0.95 (0.55

5.47)

]

pg/ml in high-disease activity group and [2.78(1.91

8.18)

]

pg/ml and [0.72 (0.57

5.14)

]

pg/ml in moderate/low-disease activity group

both higher than those in control group (

0.01). There was no significant difference between high-disease activity group and moderate/low-disease activity group in terms of TNF-α and IL-1β level distributions. PLT had positive correlations with tender joint counts

swelling joint counts

morning stiffness

VAS

DAS28 (4) ESR

CRP

and ESR (

0.01). TNF-α had positive correlations with tender joint counts

VAS

DAS28 (4) ESR

and ESR (

0.05). IL-1β had positive correlation with ESR (

=0.179

0.001) only. None of PLT

TNF-α

and IL-1β was related to the CCP

and GPI (

>0.05). Conclusion PLT and TNF-α can serve as

the sensitive indexes of RA activity

while IL-1β only partly reflects RA activity.

关键词

类风湿关节炎疾病活动性血小板肿瘤坏死因子-α白细胞介素-1β

Keywords

rheumatoid arthritisdisease activityplatelettumor necrosis factor-αinterleukin-1β

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