类风湿性关节炎患者血清GM-CSF、IL-6、IL-17和TNF-α的水平测定及临床意义

doi:10.3969/j.issn.1673-8640.2013.03.001

摘要/Abstract

摘要： 目的　检测类风湿性关节炎（RA）患者血清中性粒细胞巨噬细胞集落刺激因子（GM-CSF）、白细胞介素6（IL-6）、白细胞介素17（IL-17）和肿瘤坏死因子α（TNF-α）的水平，探讨这些细胞因子在RA发病过程中的意义。方法　收集门诊RA患者血清81例（静止期36例、活动期45例），健康对照组血清50例，评估RA患者疾病活性分数28（DAS28），应用酶联免疫吸附试验（ELISA）检测血清中GM-CSF、IL-6、IL-17和TNF-α的水平，结果用中位数（四分位数间距）表示。结果　GM-CSF在静止期、活动期RA患者和健康对照组血清中的浓度分别为12.7（9.7）、27.4（34.8）和6.2（5.2）pg/mL；IL-6在3组血清中的浓度分别为8.5（10.5）、47.1（43.8）和4.7（5.3）pg/mL；IL-17在3组血清中的浓度分别为19.3（16.4）、23.4（19.5）和20.8（16.1）pg/mL；TNF-α在3组血清中的浓度分别为42.7（37.2）、76.2（42.4）和34.1（21.9）pg/mL；活动期RA患者血清中GM-CSF、IL-6和TNF-α的水平显著高于静止期RA患者和健康对照组（P＜0.01）；静止期RA患者血清中GM-CSF、IL- 6和TNF-α的水平显著高于健康对照组（P＜0.05）；IL-17在3组间差异无统计学意义（P＞0.05）。RA患者组中，GM-CSF与IL-6和TNF-α显著相关（r＝0.637、0.738，P均＜0.001）；GM-CSF与IL-17无相关性（r＝0.171，P＝0.426）。RA患者DAS28与GM-CSF、IL-6和TNF-α显著相关（r＝0.583、0.656、0.758，P均＜0.001）。结论　GM-CSF、IL-6和TNF-α在RA的发病过程中具有重要作用； GM-CSF对于调节RA 患者IL-6和TNF-α的水平可能具有重要意义。

关键词: 中性粒细胞巨噬细胞集落刺激因子, 白细胞介素6, 白细胞介素17, 肿瘤坏死因子α, 类风湿性关节炎

Abstract: Objective　To determine the concentrations of serum granulocyte-macrophage colony stimulating factor(GM-CSF)，interleukin 6(IL-6)，interleukin 17(IL-17) and tumor necrosis factor-alpha(TNF-α)，and investigate their significance in the pathogenesis of rheumatoid arthritis(RA). Methods　A total of 81 RA outpatients were enrolled，including 36 inactive RA patients and 45 active RA patients，and 50 healthy subjects were as controls. Disease activity score 28(DAS28) of RA patients was evaluated，and the concentrations of serum GM-CSF，IL-6，IL-17 and TNF-α were determined by enzyme-linked immunosorbent assay(ELISA). The results were expressed as median(inter-quartile range). Results　The concentrations of serum GM-CSF were 12.7(9.7) pg/mL in inactive RA group，27.4(34.8) pg/mL in active RA group and 6.2(5.2) pg/mL in control group. The concentrations of serum IL-6 were 8.5(10.5)，47.1(43.8) and 4.7(5.3) pg/mL in the 3 groups，respectively. The concentrations of serum IL-17 were 19.3(16.4)，23.4(19.5) and 20.8(16.1) pg/mL in the 3 groups，respectively. The concentrations of serum TNF-α were 42.7(37.2)，76.2(42.4) and 34.1(21.9) pg/mL in the 3 groups，respectively. The concentrations of serum GM-CSF，IL-6 and TNF-α were higher in active RA group than in inactive RA group and control group(P＜0.01). The concentrations of serum GM-CSF，IL-6 and TNF-α were higher in inactive RA group than in control group(P＜0.05). IL-17 showed no statistical significance among the 3 groups(P＞0.05). GM-CSF was significantly correlated with IL-6 and TNF-α (r＝0.637 and 0.738 ，P＜0.001). There was no correlation between GM-CSF and IL-17 (r＝0.171，P＝0.426). In RA patients，there were correlations of DAS28 with GM-CSF，IL-6 and TNF-α (r＝0.583，0.656 and 0.758，P＜0.001). Conclusions　The concentrations of serum GM-CSF，IL-6 and TNF-α play important roles in RA pathogenesis. GM-CSF is a potential role in the regulation of IL-6 and TNF-α in RA patients.

Key words: Granulocyte-macrophage colony stimulating factor, Interleukin 6, Interleukin 17, Tumor necrosis factor-alpha, Rheumatoid arthritis

汤荣华，黄建军. 类风湿性关节炎患者血清GM-CSF、IL-6、IL-17和TNF-α的水平测定及临床意义[J]. 检验医学, 2013, 28(3): 173-177.

TANG Ronghua，HUANG Jianjun. The determination and its clinical significance of serum GM-CSF，IL-6，IL-17 and TNF-α in patients with rheumatoid arthritis[J]. , 2013, 28(3): 173-177.

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