EGFR-TKI联合化疗对晚期非小细胞肺癌患者血清IGF-1和AGR2水平的影响

目的观察表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)联合化疗对非小细胞肺癌(NSCLC)患者化疗前后血清胰岛素样生长因子1(IGF-1)和前梯度蛋白2(AGR2)水平变化的影响,探讨IGF-1和AGR2能否作为评估NSCLC化疗疗效及预后的指标。方法选取68例晚期NSCLC患者给予EGFR-TKI联合化疗为试验组,并以30例健康人群为健康对照组,采用酶联免疫吸附试验(ELISA)分别测定化疗前、化疗3周后血清IGF-1、AGR2水平。采用Kanplan-Meier法分析血清IGF-1、AGR2水平变化对预后的影响。结果(1)EGFR-TKI联合化疗疾病控制率(DCR)为52.9%;(2)试验组治疗前血清IGF-1水平为(329.35±88.13)μg/L,明显高于健康对照组的(146.36±41.27)μg/L(P0.01),试验组治疗前血清AGR2水平为(16.72±6.23)ng/mL,高于健康对照组的(4.38±2.17)ng/mL(P0.01);治疗后血清IGF-1为(211.53±52.31)μg/L、AGR2水平为(9.72±3.56)ng/mL,均比治疗前明显降低(均P0.01);NSCLC患者血清IGF-1与AGR2水平呈正相关(r=0.489,P0.01);(3)治疗有效组患者血清IGF-1水平为(128.62±48.24)μg/L、AGR2水平为(7.22±4.27)ng/mL,分别较治疗前IGF-1[(334.23±82.11)μg/L]、AGR2[(18.43±6.17)ng/mL]明显下降(均P0.01)。Kanplan-Meier分析显示,治疗后血清IGF-1、AGR2水平的高低对预后有明显影响。结论 IGF-1、AGR2水平在评估EGFR-TKI联合化疗对晚期NSCLC的疗效及预后有着潜在的临床价值。     

VEGF、bFGF与血管内皮抑素在NSCLC治疗中的相关性研究

目的分析晚期非小细胞肺癌(NSCLC)患者化疗联合血管内皮抑素治疗前后外周血中血管内皮生长因子(VEGF)和碱性成纤维生长因子(bFGF)的变化,探讨两者在NSCLC中的应用价值。方法用酶联免疫吸附试验(ELlSA)检测32例晚期NSCLC患者化疗联合血管内皮抑素治疗前后临床疗效及VEGF和bFGF水平。结果晚期NSCLC患者经化疗联合血管内皮抑素治疗后临床受益率达80.6%。治疗前后血浆VEGF水平的差异无统计学意义(P>0.05),血浆bFGF水平在治疗前后的差异有统计学意义(P<0.05)。治疗前后血浆bFGF水平的变化与临床受益呈正相关,结果有统计学意义(P<0.01)。结论在化疗联合血管内皮抑素治疗晚期NSCLC中,bFGF是一个较好的预测疗效的指标。     

血清IL-31、IL-33水平与中晚期子宫内膜癌患者新辅助化疗效果的关系

目的 分析血清白细胞介素-31(IL-31)、白细胞介素-33(IL-33)水平与中晚期子宫内膜癌患者新辅助化疗效果的关系.方法 选取2017年1月至2020年1月在该院接受新辅助化疗[AP方案(阿霉素+顺铂化疗)]的123例中晚期子宫内膜癌患者作为研究对象,每3周为1个化疗周期,均化疗3个周期后观察至少1个月,评价入...     

程序性细胞死亡因子5在活动性类风湿关节炎患者中的水平变化

目的：探究程序性细胞死亡因子5（programmed cell death factor 5,PDCD5）在类风湿关节炎（rheumatoid arthritis, RA）患者中的表达情况,并探讨PDCD5在RA发病中的可能作用。方法：采用酶联免疫吸附试验检测36例活动性RA患者和35例骨关节炎（osteoarthritis,OA）患者的血清和关节液中的PDCD5、白细胞介素6（interleukin 6,IL-6）水平,另以33名健康人的血清PDCD5水平作为对照（对照组）,比较3组间以上各指标水平的差异。同时再检测RA患者的C反应蛋白（C reaction protein, CRP）、红细胞沉降率（erythrocyte sedimentation rate, ESR）、类风湿因子（rheumatoid factor,RF）和环瓜氨酸肽（cyclic citrullinated peptide, CCP）,记录其肿胀关节数（swollen joint count,SJC）、疼痛关节数（tender joints count, TJC）,作为疾病活动指数参考指标。结果：RA组的血清PDCD5水平[（32.47±12.79） ng/mL]显著高于OA组[（12.79±9.84） ng/mL]及对照组[（18.40±18.97） ng/mL];RA组关节液中的PDCD5水平[（47.75±21.94） ng/mL]亦高于OA组[（19.33±11.25） ng/mL]。RA患者血清中的PDCD5水平与IL-6水平呈负相关（r=-0.431）,但在关节液中未观察到两者间具有相关性。Pearson分析显示,RA患者血清中的PDCD5水平与CRP、ESR、SJC、TJC呈负相关（R值分别为-0.523、-0.701、-0.845、-0.943）,但与CCP及RF水平间无统计学相关性。结论：活动性RA患者的血清及关节液中PDCD5的水平升高,而其表达失调可能与IL-6水平相关。     

非小细胞肺癌患者呼出气冷凝液VEGF检测的临床意义

目的测定非小细胞肺癌患者(NSCLC)呼出气冷凝液(EBC)中血管内皮生长因子(VEGF)并研究其临床意义。方法收集40例经病理确诊的NSCLC患者、20例稳定期的慢性阻塞性肺疾病(COPD)患者和20例健康体检者的EBC和血清标本,采用酶联免疫吸附法(ELISA)分别检测EBC和血清中VEGF水平。结果①NSCLC组EBC和血清中VEGF水平[(11.7±6.1)pg/mL、(310.5±23.9)pg/mL]显著高于COPD组[(6.3±4.9)pg/mL、(217.1±14.7)pg/mL]及正常对照组[(3.6±1.2)pg/mL、(162.5±16.5)pg/mL]。②EBC和血清中VEGF水平与NSCLC患者的TNM分期及淋巴结转移呈正相关,与肺癌病理类型及患者性别、年龄、吸烟史无密切关系。结论检测EBC中VEGF有助于肺癌的早期诊断、病情进展及预后判断。     

安罗替尼联合化疗治疗驱动基因阴性晚期非小细胞肺癌的疗效及对血清VEGF、bFGF、MMP-9水平的影响

目的 安罗替尼联合化疗治疗驱动基因阴性晚期非小细胞肺癌(NSCLC)的疗效及安全性.方法 前瞻性选取2018年7月至2020年6月就诊于安徽医科大学附属宿州医院的晚期NSCLC患者60例为研究对象,随机数字表法分为观察组(n=30)和对照组(n=30).观察组予以安罗替尼联合化疗治疗,对照组予以单纯化疗治疗.比较两组客...     

沙利度胺联合GP方案治疗晚期非小细胞肺癌的临床研究

目的探讨沙利度胺联合化疗治疗晚期非小细胞肺癌的近期有效率及其对血清中VEGF、bFGF、TNF-α的影响。方法70例晚期非小细胞肺癌随机分为2组,联合组：GP＋沙利度胺治疗,共35例。化疗组：单纯使用GP方案化疗。结果联合组的治疗有效率（CR＋PR）为51．4％,化疗组有效率为34．3％,两组有效率比较,差异无统计学意义（P〉0．05）。联合组中治疗有效的患者,血清VEGF较前明显降低,差异有统计学意义（P〈0．05）;化疗组中治疗有效的患者,血清VEGF较前降低,但差异无统计学意义（P〉0．05）。两组中化疗无效的患者治疗后,血清VEGF水平均比治疗前显著升高,差异有统计学意义（P〈0．05）。联合组治疗后,血清TNF—α较前明显降低,差异有统计学意义（P〈0．05）;化疗组治疗后,血清TNF—α含量较前无明显变化（P〉0．05）。两组患者治疗前后,血清bFGF含量无明显变化（P〉0．05）。结论沙利度胺联合GP能改善晚期非小细胞肺癌患者的近期有效率;沙利度胺联合化疗可抑制肿瘤细胞VEGF的产生;沙利度胺能够抑制肿瘤细胞TNF-α的产生。     

重组人血管内皮抑制素联合化疗治疗晚期恶性肿瘤的临床研究

目的观察重组人血管内皮抑制素(恩度)联合化疗治疗晚期恶性肿瘤的临床疗效。方法对51例晚期恶性肿瘤患者进行恩度联合化疗治疗,恩度7.5 mg/(m2.d)加入500 mL生理盐水中静脉滴注,连续给药14 d,休息7 d,21 d为1个周期,联合化疗的方法根据患者不同疾病给予不同的化疗方案。观察患者临床疗效及毒副反应。结果治疗2个周期后,非小细胞肺癌(NSCLC)患者临床受益率为83.9%,总收益率为80.4%;随访至2010年7月底止,共有18例患者仍然生存,33例死亡,其中31例NSCLC患者中,生存12例,死亡19例,中位生存期为14个月。毒副反应主要是与化疗相关的骨髓抑制,其中Ⅲ~Ⅳ度毒副反应的患者达17例(33.3%),其余无毒副反应均为Ⅰ度或Ⅱ度。结论恩度联合全身化疗治疗晚期恶性肿瘤获得了较好的临床收益率和生存期,且毒副反应均可以耐受,值得临床进一步推广应用。     

Maintenance immunotherapy in recurrent or metastatic squamous cell carcinoma of the head and neck

The purpose of this study was to determine the efficacy and safety of a maintenance immunotherapy regimen administered to patients with recurrent/metastatic squamous cell carcinoma of the head and neck (RMHN) who showed clinical benefit from docetaxel, ifosfamide, and cisplatin chemotherapy (DIP). Every 4 weeks, patients with RMHN received 60 mg/m docetaxel on day 1, and 1200 mg/m ifosfamide and 20 mg/m cisplatin on days 1 to 4. Low-dose subcutaneous interleukin-2 and oral 13-cis-retinoic acid were administered as maintenance immunotherapy to patients who showed a clinical benefit (complete or partial response, disease stability). The primary end point was response; secondary end points were progression-free survival, overall survival, toxicity, and evaluations of lymphocytes, natural killer cells, and serum vascular endothelial growth factor (VEGF). After a median follow-up of 22 months, 263 courses of chemotherapy were administered to the 54 patients. The overall response rate was 59%. Forty-two patients (78%) had a clinical benefit and received 185 courses of maintenance immunotherapy. Median progression-free survival and overall survival were 11.1 and 21.8 months, respectively. Statistically significant, progressive increases in lymphocytes and natural killer cells and a decrease in VEGF were observed in patients treated with maintenance immunotherapy. The toxicity was relatively well tolerated and caused no death. Outpatient administration of DIP, followed by low-dose interleukin-2 and 13-cis-retinoic acid, was generally well tolerated and showed promising activity against RMHN. Longitudinal changes in lymphocytes, natural killer cells, and VEGF might be useful biomarkers for response and survival.     

类风湿关节炎治疗前后血清基质金属蛋白酶-3的变化

目的:检测活动期类风温关节炎(RA)患者治疗前后血清基质金属蛋白酶-3(MMP-3)水平,探讨MMP-3在RA中的作用,为RA的疗效判断寻找新的指标。方法:分别检测45例RA患者和20例健康体检者血清MMP-3水平。MMP-3检测采用酶联免疫吸附法(ELISA)。结果:治疗前活动期RA患者血清MMP-3水平为(372.34±198.24)ng/mL,显著高于正常对照组的(27.46±16.83)ng/mL(P<0.001)。治疗前活动期RA患者血清MMP-3水平与DAS评分呈正相关关系(r=0.526,P<0.05)。治疗后MMP-3水平下降,其中病情缓解者下降差异有显著性[(361.27±193.83)ng/mLvs(192.52±107.33)ng/mL,P<0.05];进一步的相关分析显示,治疗后MMP-3的降低水平与DAS评分下降值亦呈正相关关系(r=0.493,P<0.05)。结论:RA患者血清MMP-3水平显著升高,可作为疾病活动性指标之一,并可作为了解RA治疗效果和预后评估的重要手段。     

多发性骨髓瘤患者血清血管内皮生长因子和白介素-17水平变化的临床意义

本研究旨在探讨多发性骨髓瘤患者血清中血管内皮生长因子(VEGF)和白介素-17(IL-17)水平变化的临床意义。初治MM患者40例,其中临床Ⅰ期9例,Ⅱ期18例,Ⅲ期13例。在40例中25例采用长春新碱、阿霉素和地塞米松(VAD)方案治疗,15例采用硼替佐米和地塞米松(BD)方案治疗。正常对照组20例。用ELISA方法检测化疗前后血清VEGF和IL-17的水平。结果表明,MM组的VEGF和IL-17水平明显高于正常对照组(P<0.01),且随着临床分期,VEGF水平和IL-17水平呈递增趋势(P<0.05)。VEGF和IL-17水平在Ⅲ期高于Ⅰ期组和Ⅱ期组(P<0.05)。MM患者血清VEGF水平、血肌酐、血轻链λ、尿轻链λ、IL-17水平、C反应蛋白、血钙、β2-微球蛋白水平等均明显高于正常对照组(P<0.01)。治疗后VEGF和IL-17水平较治疗前明显下降(P<0.05),BD方案化疗效果较VAD方案更为显著(P<0.05)。结论:检测血清VEGF和IL-17水平对于MM患者的临床分期、病情判断和疗效观察具有重要意义。     

二线单药化疗联合PD-1/PD-L1抑制剂对晚期非小细胞肺癌的临床疗效

目的 探讨二线单药化疗联合程序性死亡受体(PD)-1/PD-L1抑制剂对晚期非小细胞肺癌(NSCLC)患者的临床疗效.方法 前瞻性选取山东大学齐鲁医院于2018年12月至2020年3月收治的晚期NSCLC患者82例,采用随机数字表法分为观察组(n=41)与对照组(n=41).对照组单用培美曲塞化疗治疗;观察组给予培美曲...     

核苷酸结合寡聚化结构域样受体蛋白3和caspase-1表达与非小细胞肺癌患者疾病进展的关系

目的观察非小细胞肺癌(non-small cell lung cancer,NSCLC)患者外周血核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)及血清caspase-1的表达情况,探讨其与NSCLC患者疾病进展的关系。方法252例NSCLC患者采用吉西他滨+顺铂方案化疗2个周期后进行疗效评估,对达临床控制的125例患者随访2年,根据有无进展(或死亡)分为进展组102例和无进展组23例。比较2组外周血NLRP3表达及血清caspase-1、P53、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平;绘制ROC曲线,评估外周血NLRP3表达及血清caspase-1水平预测NSCLC患者经吉西他滨+顺铂方案化疗临床控制后疾病进展的效能;采用Cox回归分析外周血NLRP3表达及血清caspase-1水平对经吉西他滨+顺铂方案化疗临床控制的NSCLC患者疾病进展的影响。结果进展组外周血NLRP3mRNA相对表达量[2.00(1.92,4.02)]及血清caspase-1[296.56(263.52,360.75)ng/L]、P53[8.12(6.32,9.41)u/mL]、VEGF[398.13(341.12,426.59)ng/L]水平均高于未进展组[1.36(0.86,1.75)、196.56(141.11,211.32)ng/L、3.68(3.12,4.87)u/mL、289.42(245.16,311.32)ng/L](P<0.05)。NLRP3mRNA、caspase-1分别以1.361、143.215ng/L最佳截断值,预测疾病进展的AUC分别为0.859(95%CI:0.771~0.947,P<0.001)、0.851(95%CI:0.751~0.951,P<0.001);外周血NLRP3mRNA相对表达量≥1.361、caspase-1≥143.215ng/L是NSCLC经吉西他滨+顺铂方案化疗临床控制后疾病进展的独立危险因素(OR=2.696,95%CI:1.627~5.468,P<0.001;OR=3.377,95%CI:2.034~5.606,P<0.001)。结论NSCLC患者经吉西他滨+顺铂方案化疗临床控制后疾病进展可能与外周血NLRP3及血清caspase-1过表达有关,NLRP3、caspase-1对预测疾病进展、指导NSCLC的治疗及改善患者预后有重要作用。     

Effects of interleukin 2 therapy on lymphocyte magnesium levels

Interleukin 2 (IL-2) can cause partial or complete tumor regression in approximately 20% of patients with renal cell carcinoma. Among the many physiologic effects of IL-2, decreased serum levels of the divalent cations magnesium (Mg) and calcium have been demonstrated, with corresponding decreases in their urinary excretion. We investigated the effect of IL-2 on lymphocyte Mg levels among patients receiving three different dosing regimens. Twenty-eight patients with metastatic renal cell carcinoma were treated with high-dose intravenous, low-dose intravenous, or subcutaneous IL-2 therapy. Serum ionized Mg, urinary Mg, and peripheral blood mononuclear cell Mg levels were measured in samples from patients during treatment and compared with pretreatment levels. Serum Mg and ionized Mg levels decreased for all patients within 12 hours of treatment (P <.005) and remained low for the duration of therapy. Urinary Mg decreased in parallel with serum levels in all patients (P <.005). The peripheral blood mononuclear cell Mg content per cell increased within 24 hours of treatment (P <.005). The magnitude of these changes was similar during the first week of treatment for patients receiving intravenous or subcutaneous administration of IL-2. During IL-2 therapy, lymphocyte Mg increases coincident with serum Mg depletion. Mg availability may have functional implications for lymphocyte proliferation and integrin function.     

大蒜汁雾化吸入联合GP方案治疗中晚期非小细胞肺癌57例疗效观察

【目的】观察大蒜汁雾化吸入联合GP方案[吉西他滨（GEM）＋顺铂（DDP）]治疗中晚期非小细胞肺癌（NSCLC）的临床疗效、不良反应及对白细胞介素一6（IL一6）的影响。【方法】将113例中晚期NSCLC患者随机分为两组,治疗组（57例）采用大蒜汁雾化吸入加GP方案治疗,对照组（56例）采用单纯GP方案化疗。【结果】治疗组和对照组的有效率（CR＋PR）分别为45．6％和33．9％（P〉O．05）,临床获益率（CR＋PR＋SD）分别为80．7％和64．3％（P〈0．05）。治疗后治疗组IL一6明显降低（P〈0．05）;治疗组生存质量高于对照组（P〈0．05）;对照组白细胞减少、血红蛋白下降和恶心、呕吐等病例数多于治疗组（P〈0．05）。【结论】大蒜汁雾化吸入与化疗同时应用治疗NSCLC,能降低炎症因子IL一6及减轻化疗的某些不良反应,提高临床获益率,改善患者生存质量。     

Blood levels of angiogenin and vascular endothelial growth factor are elevated in myelodysplastic syndromes and in acute myeloid leukemia

Angiogenesis is of prognostic importance not only in solid tumors but also in malignant blood diseases. We measured levels of vascular endothelial growth factor (VEGF), angiogenin (ANG), and basic fibroblast growth factor (bFGF) in peripheral blood samples from 65 patients with myelodysplastic syndrome (MDS), from 25 patients with de novo acute myeloid leukemia (AML), and from 50 healthy donors. In matched samples, VEGF levels in serum were substantially higher than VEGF levels in plasma (380.7 +/- 56 pg/ml vs. 45.3 +/- 4.5 pg/ml, mean +/- SEM, p < 0.001), whereas serum and plasma levels of ANG were comparable and significantly correlated (r = 0.8; p < 0.01). Compared to normal controls (1.3 +/- 0.09 pg), serum levels of VEGF corrected for the peripheral blood platelet count (VEGF/10(6) platelets, VEGF(PLT)) were elevated in patients with refractory anemia (RA; 3.1 +/- 0.8 pg, p < 0.01), and reached maximal values in patients with advanced stage MDS (RAEB, RAEB-t) (3.5 +/- 0.6 pg, p < 0.001), de novo AML (3.6 +/- 1.1 pg, p < 0.05), and chronic myelomonocytic leukemia (CMML; 3.7 +/- 0.9 pg; p < 0.001). Levels of soluble ANG were elevated in RA (351 +/- 25.7 ng/ml, p < 0.001), in RAEB/RAEB-t (402 +/- 17.9 ng/ml; p < 0.001), in CMML (413.8 +/- 29.5 ng/ml; p < 0.001), and in patients with AML (305.1 +/- 17.1 ng/ml; p < 0.01, controls 255.4 +/- 8.1 ng/ml). Serum bFGF was neither elevated in MDS nor in AML patients. These results suggest that VEGF(PLT) is a marker of disease progression in MDS. Moreover, we show for the first time that elevated blood levels of ANG can be found in patients with myeloid malignancies, suggesting a role of ANG in the pathogenesis of these diseases.     

Phase 2 study of the g209-2M melanoma peptide vaccine and low-dose interleukin-2 in advanced melanoma: Cancer and Leukemia Group B 509901

High-dose interleukin-2 (IL-2) is the only approved immunologic therapy for advanced melanoma, but response rates are low and significant toxicities limit treatment to otherwise healthy patients. g209-2M is a nanopeptide engineered to mimic an epitope of the gp100 melanocyte differentiation protein that is recognized in a human leukocyte antigen (HLA)-restricted manner by melanoma tumor-infiltrating lymphocytes in some patients. Previous reports indicated that administration of the g209-2M peptide could induce g209-reactive circulating T cells in patients with melanoma and that the combination of g209-2M and high-dose IL-2 might be a more active treatment than high-dose IL-2 alone. Low-dose IL-2 is not active but has significant biologic effects, and because of a different toxicity profile, it can be offered to most patients. The primary objective of this cooperative group phase 2 study was to determine the activity of the combination of g209-2M and low-dose IL-2 in advanced melanoma. Twenty-six HLA appropriate patients with advanced melanoma received subcutaneous g209-2M peptide once every 3 weeks and subcutaneous IL-2 (5 million IU/m) daily for 5 days during the first and second weeks. Patients were monitored for tumor response, toxicity, and induction of g209-reactive circulating T cells. There were no objective responses. There were no toxic deaths and no grade 4 toxicities. More than half of the patients experienced some grade 2 toxicity and one quarter experienced grade 3 toxicity. There was no convincing evidence by enzyme-linked immunospot or tetramer analysis of induction of g209-reactive circulating T cells. The combination of g209-2M and low-dose IL-2 is safe and tolerable but inactive against advanced melanoma. Absence of evidence of immunization raises concerns for peptide-based immunization strategies with concurrent IL-2.     

The 800-lb gorilla we all ignore: treatment of NSCLC in elderly and PS 2 patients

Patients with non-small cell lung cancer,NSCLC, typically have advanced disease on presentation. First-line palliative platinum-based doublet chemotherapy has emerged as the standard of care in fit, younger patients. However, patients with advanced age and/or impaired performance status have been relatively underrepresented in clinical trials. Retrospective analyses and the few existing prospective randomized trials in these populations have suggested a poorer overall prognosis, yet also provide evidence of benefit from systemic therapy. Toxicity is generally manageable, and in most cases, comparable to that of younger, healthier patients. There are clearly expanding roles for nonplatinum chemotherapy agents and newer targeted therapies, which have generally yielded decreased toxicity compared to platinum-based chemotherapy without sacrificing efficacy. Appropriate pretreatment assessment and proper patient selection is of paramount importance; it is imperative to treat patients who are most likely to garner benefit. In summary, data suggest that these relatively neglected populations of NSCLC patients can be safely treated, and can benefit from palliative systemic therapy. Single-agent chemotherapy is generally recommended over combination chemotherapy, although investigation of newer targeted therapies or alternative agents may allow for combination therapy in the near future. Further prospective investigation is absolutely warranted.     

恩度联合DP化疗方案治疗晚期非小细胞肺癌的临床研究

目的探讨恩度联合DP化疗方案(多西紫杉醇+顺铂)治疗晚期非小细胞肺癌患者的近期临床疗效,评价其临床应用的安全性和耐受性。方法 45例晚期非小细胞肺癌患者给予DP方案化疗同时联合恩度7.5 mg/m2,连用2周后暂停1周为1周期,至少完成2周期,观察近期疗效、疾病进展时间及不良反应。结果 45例患者中部分缓解18例(40.0%),稳定17例(37.8%),进展10例(22.2%),有效率为40.0%,临床受益率为77.8%。不良反应主要为骨髓抑制和胃肠反应,患者经对症处理后可以耐受。结论恩度联合含铂类DP化疗方案一线治疗晚期非小细胞肺癌是一种安全有效的方案。     

白细胞介素-21及其受体在类风湿关节炎患者血清及外周血单个核细胞中的表达

目的检测类风湿关节炎(RA)患者血清、外周血单个核细胞(PBMC)中白细胞介素-21(IL-21)及其受体(IL-21R)的表达水平,探讨二者之间的相关性及其在RA病理机制中的作用。方法血清IL-21含量采用酶联免疫吸附试验检测,套式实时荧光定量聚合酶链反应法测定PBMC中IL-21R mRNA水平。结果 RA患者组血清中IL-21含量和PBMC中IL-21RmRNA表达水平均高于健康对照组,差异有统计学意义(P<0.01);RA活动期IL-21、IL-21RmRNA水平明显高于非活动期,RA患者经治疗症状改善者IL-21、IL-21R含量明显下调,分别下降21.0%、30.3%,治疗前后比较差异有统计学意义(P<0.01);IL-21和IL-21R表达水平与RA患者关节功能分级有显著相关性,Ⅲ级以上与Ⅰ级、Ⅱ级相比2项指标差异有统计学意义(P<0.01)。结论 IL-21与IL-21R水平检测对RA的诊断和治疗有重要的临床意义。