类风湿关节炎患者血清铁调素与贫血及疾病活动性的关系

目的 探讨血清铁调素（hepcidin,Hepc）在类风湿关节炎（rheumatoid arthritis,RA）患者中的作用及其与贫血及病情活动度的关系.方法 用酶联免疫吸附法测定80例RA患者（RA组）、20例其他结缔组织病（connective tissue disease,CTD）患者（其他CTD组）、20例健康志愿者（健康对照组）血清Hepc水平及RA患者白介素（interleukin,IL）-6、IL-1β、肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）水平,比较3组间Hepc的差异,分析RA患者中贫血与非贫血、不同病情活动度间Hepc及其他细胞因子水平差异,以及RA患者血清Hepc水平与其他因素间的相关性.结果 血清Hepc水平在RA组中明显升高,与其他CTD组及健康对照组相比,差异有统计学意义（均P〈0.01）.血清Hepc升高的RA患者病情活动度评分和IL-6浓度均高于Hepc正常组（均P〈0.05）.RA贫血者血清IL-6水平明显高于非贫血者（P〈0.05）,TNF-α、IL-1β及Hepc在RA贫血者与非贫血者间差异无统计学意义（均P〉0.05）.RA高度活动者的血红蛋白浓度明显低于非高度活动者（P〈0.05）,而Hepc水平则较非高度活动者升高,但差异无统计学意义（P=0.063）.RA患者血清Hepc水平与IL-6（r=0.298）和RF（r=0.264）均存在正相关（均P〈0.05）;与DAS28存在明显正相关（r=0.359,P〈0.01）.结论 Hepc可能作为一个炎性因子参与了RA的发展,检测Hepc可能作为RA病情活动度和预后的评价指标之一.

Correlation of Serum Hepcidin with Anemia and Disease Activity of Patients with Rheumatoid Arthritis

Objective To investigate the role of hepcidin （Hepc） in patients with Rheumatoid Arthritis （ RA）, and its correlation to anemia and disease activity. Methods Blood samples from 80 patients with RA, 20 patients with other connective tissue diseases （CTD） and 20 healthy controls were measured by ELISA. The levels of serum Hepc, IL-6, IL-1β, TNF-α and their correlation with anemia and Disease Activity Score for 28 joints （DAS28） were analyzed. Results Serum Hepc was found to be higher in patients with RA than in patients with other CTD and healthy controls （P 〈0. 01 ）. The DAS28 scores and the level of IL-6 were found to be higher in patients with RA and their serum Hepc level was higher than patients with normal serum Hepc level （P 〈 0.05 ）. The level of IL-6 was higher in patients with RA and anemia than in patients with RA but without anemia （ P 〈 0.05 ） , on the other hand, no difference was observed on the levels of IL-1β, TNF-α and Hepc between the two groups of patients with RA. The level of hemoglobin in patients with RA and high DAS28 scores （ 〉 5.1 ） was lower than patients with RA and low DAS28 scores （ ≤5.1 ）（P 〈 0.05）, and the level of Hepc was higher at the same time, but no significant difference was found （P = 0. 063 ）. In patients with RA, the level of serum Hepc was positively correlated with IL-6, Rheumatoid Factors （RF） and DAS28 scores （ r = 0. 298, P 〈 0. 05 ; r = 0. 264, P 〈 0. 05 ; r = 0. 359, P 〈 0. 01 ）, respectively. Conclusions Hepc can be considered as an important inflammatory factor in the pathogenesis of RA. The correlation between Hepc with IL-6, RF and diseases activity suggests that Hepc maybe used as a surrogate marker for disease activity and prognosis of RA.