类风湿关节炎患者抗血管内皮细胞抗体、血管内皮生长因子和白细胞介素-17的检测及意义

目的 通过对类风湿关节炎(RA)患者血清抗血管内皮细胞抗体(AECA)、血浆血管内皮生长因子(VEGF)和白细胞介素-17(IL-17)的检测,旨在探讨AECA、VEGF、IL-17在RA患者发病、病情进展中的相关性及其内在联系.方法 采用间接免疫荧光法(IIF)和双抗体夹心酶联免疫吸附试验(ELISA)法检测86例RA、45例骨关节炎(OA)、30例健康对照AECA的阳性率和VEGF、IL-17水平,VEGF、IL-17水平与红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)等指标进行相关性分析.结果 RA患者AECA阳性率为8.1%,高于OA患者的阳性率2.2%(t:2.133,P<0.05)和健康对照的阳性率0(t=2.562,P<0.05);RA活动期AECA阳性率为16.7%,高于RA缓解期的阳性率3.6%(t=2.105,P<0.05);RA患者血浆IL-17和VEGF水平显著高于OA组(t=2.02、t=2.106,P<0.05)和健康对照组(t=2.413、t=2.469,P<0.05);RA患者活动期血浆IL-17和VEGF水平明显高于RA缓解组(t=2.315、t=2.232,P<0.05)及健康对照组(t:2.985、t=2.753,P<0.01);RA缓解组与健康对照组无明显差异(t=1.475、t=1.326,P>0.05);RA患者AECA滴度、血浆IL-17、VEGF水平与ESR、hs-CRP、RF的指标呈正相关.结论 AECA、VEGF、IL-17三者与RA的发病、病情活动存在一定的关系,IL-17、VEGF水平变化及AECA的滴度可作为临床观察RA病情活动、判断疗效及预后等方面的参考指标.

Detections and clinical values of anti-endothelial cell antibodies, vascular endothelial growth factor and interleukin-17 in patients with rheumatoid arthritis

Objective To.investigate the clinical significance of plasma anti endothelial cell antibodies (AECA) , vascular endothelial growth factor (VEGF) and interleukin-17 (IL-17) in patients with rheumatoid arthritis. Methods AECA, VEGF, and IL-17 were detected in 86 cases of rheumatoid arthritis ,45 cases of osteoarthritis (OA) and 30 healthy controls by indirect immunofluorescence(IIF) and by double antibody sandwich enzyme-linked immunosorbent assay(ELISA). The correlations among above results, erythrocyte sedimentation rate (ESR) , high-sensitivity C-reactive protein (hs-CRP) and rheumatoid factor (RF) were analyzed . Results The positive rate of AECA in patients with RA (8. 1%) was much higher than that in patients with OA(2.2%)(t=2. 133,P<0.05) and in the normal group(0) (t = 2. 562,P <0. 05). The positive rate of AECA in active RA patients (16.7%) was much higher than that of RA remission group(3.6%)(t =2. 105, P <0. 05). The plasma levels of IL-17 and VEGF of RA patients were significantly higher than that of OA patients (t=2.02,t=2. 106,P<0. 05) and the normal control (t =2. 413,t =2. 469,P <0. 05) ;Plasma levels of IL-17 and VEGF of active RA patients were significantly higher than that of RA remission group (t = 2. 315, t = 2. 232,P <0. 05) and healthy control group(t = 2. 985, t = 2. 753,P < 0. 01), but not significant different between that of RA remission group and healthy control group(t = 1. 475 ,t = 1. 326,P >0. 05) ;The titer of AECA, plasma IL-17 and VEGF of RA patients were positively correlated with ESR,hs-CRP,and RF. Conclu-sions AECA,VEGF and IL-17 are cor-related with the pathogenesis and activity of RA. They can be used as important indicators for the disease activity, therapeutic effect, and prognosis of patients with RA.