类风湿关节炎患者血清和关节液细胞因子水平的变化及临床意义

目的探讨幼年类风湿关节炎(JRA)及类风湿关节炎(RA)患者IL-6、IL-8、sIL-2R和TNF-α等细胞因子(CK)水平的变化,及其与风湿活动的传统指标血沉(ESR)和C-反应蛋白(CRP)的相关性。方法采用夹心ELISA法，对30例JRA和34例RA患者的血清中，4例JRA、7例RA、6例骨性关节炎(OA)和9例半月板损伤(MT)患者的关节液中IL-6、IL-8、sIL-2R和TNF-α的水平进行检测。结果①30例JRA、34例RA患者血清IL-6和sIL-2R的水平与对照组相差非常显著(P〈0.01)；30例JRA患者血清IL-8水平与对照组比较相差显著(P〈0.05)。②JRA全身型、少关节型患者血清IL-8、sIL-2R的水平和JRA多关节型患者血清IL-6的水平与对照组相差非常显著(P〈0.01)。③4例JRA及7例RA患者关节液sIL-2R的水平和RA患者关节液的IL-6水平与对照组相差显著(P〈0.05)。④JRA患者血清IL-6和sIL-2R的水平与ESR和CRP的变化呈明显的相关关系(r值分别为0.532和0.621)。结论①IL-6、sIL-2R的水平与JRA、RA病的活动性有关，是类风湿活动性的主要指标。②sIL-2R不仅参与JRA和RA的全身病理损伤,而且是引起关节局部损伤的主要CK,IL-6也参与JRA关节局部的病理损伤,在RA关节局部损伤似乎更为重要。③IL-8主要参与JRA的全身病理损伤,对关节局部病理损伤似乎并不重要。

Detection and their clinical significance of cytokines levels in serum and synovial fluid from patients with rheumatoid arthritis

Aim To study cytokine(CK) changes of IL-6,IL-8,sIL-2R and TNF-a levels in sera from patients with juvenile rheumatoid arthritis(JRA) and rheumatoid arthritis(RA) and its correlation with the conventional inflammation indexes,erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP). Methods Levels of IL-6,IL-8,sIL-2R and TNF-a in serum from 30 JRA patients and 34 RA patients,in the synovial fluid (SF)from 4 JRA patients,7 RA patients,6 osteoarthritis(OA) patients and 9 meniscitis(MT) patients were detected by sandwich ELISA. Results As compared with control group,① levels of IL-6 and SIL-2R in sera from 30 JRA patients and 34 RA patients and levels of IL-8 in sera from 30 JRA patients possessed marked difference P∨ 0.01 and P∨ 0.05,respectively.② There were significant difference among serum IL-8 and sIL-2R levels from systemic JRA patients, pauciaticular JRA patients,and serum IL-6 levels from polyarticular JRA patients(P<0.01). ③ There were remarkable difference among SF sIL-2R levels from 4 JRA patients and 7 RA patients and in SF IL-6 levels from 7 with RA patients.④ There were obvious correlativity between serum IL-6,sIL-2R levels and changes of serum ESR and CRP from the JRA patients(r=0.532 and r=0.621,respectively). Conclusion ① IL-6 and sIL-2R exhibit a close correlativity with the activity of JRA and RA,which is the main index of activity of JRA and RA diseases.② sIL-2R might not only participate in systemic pathologic process in JRA and RA diseases,but also serves as a major CK in local articular injuries.IL-6 participates in local articular injuries too,and seems to play a more important role in local articular injuries of RA.③ IL-8 may participate in systemic pathologic process of JRA,but play a minor part in local articular injuries.