类风湿性关节炎活动性指标血清IL-2,sIL-2R,HA,VEGF的水平变化及临床意义

目的 :通过对类风湿关节炎 (RA)活动性指标血清白介素 - 2 (IL - 2 )、可溶性白介素 - 2受体 (sIL -2R)、透明质酸 (HA)、血管内皮生长因子 (VEGF)水平变化的测定 ,探讨它们与病情活动的相关性及临床意义。方法 :采用RIA和ELISA法对类风湿关节炎患者活动组、缓解组及正常对照组进行IL - 2、sIL - 2R、HA、VEGF测定 ,并从敏感性、特异性方面进行比较分析。结果 :活动组RA患者血清sIL - 2R、HA、VEGF的含量显著高于缓解组及正常对照组 (p <0 0 1 ) ,而活动组RA患者血清IL - 2的含量却显著低于缓解组及正常对照组 (p <0 0 1 )。VEGF的特异性最强 (93 3% ) ,敏感性为 93 3%。 结论 :与血清IL - 2、sIL - 2R、HA相比 ,血清VEGF水平测定更有助于类风湿关节炎活动性的监测 ,对该病的治疗及预后均有一定的意义

Clinical Significance of the Changes of Serum Levels of the Rheumatoid Activity Markers IL-2, sIL-2R, HA and VEGF

Objective To explore the relationship between rheumatoid activity and serum levels of the cytokines interleukin-2 (IL-2), soluble interleukin-2 receptor (sIL-2R), hyaluronic acid (HA), vascular endothelial growth factor (VEGF) in patients with rheumatoid arthritis. Methods Serum IL-2, HA (with RIA) and sIL-2R, VEGF (with ELISA) levels were determined in 30 controls, 30 patients with active rheumatoid arthritis and 30 patients with rheumatoid arthritis in remission. Sensitivity and spectificity for each marker were analyzed. Results In patients with active rheumatoid arthritis, the serum levels of sIL-2R, HA, VEGF were significantly higher and serum levels of IL-2 significantly lower than those in patients in remission and controls ( p <0 01). Determination of VEGF levels possessed the highest specificity (93 3%) and also a high sensitivity (93 3% as well). Conclusion Determination of the serum levels of any of these markers was valuable for monitoring the activity of the rheumatoid process. It is more desirable to take measarements of VEGF levels due to its highest specificity.