类风湿关节炎患者血清同型半胱氨酸和脂联素的表达及其意义

目的探讨类风湿关节炎(RA)患者血清同型半胱氨酸(HCY)、脂联素(ADP)水平的变化及其意义。方法采用酶联免疫吸附试验(ELISA)法检测RA患者治疗前后血清HCY、ADP水平,并与正常对照组及糖尿病对照组比较。结果 RA组血清HCY水平为(6.63±2.75)μmol/L,显著高于正常对照组(4.30±2.12)μmol/L(P=0.003),与糖尿病组(6.69±2.98)μmol/L比较差异无统计学意义(P>0.05);RA组血清ADP水平为(208.12±74.06)μg/L,低于正常对照组(241.73±82.05)μg/L,高于糖尿病对照组(195.95±62.03)μg/L,3组间差异无统计学意义(P>0.05)。治疗6个月后,RA组应用甲氨蝶呤者血清HCY水平显著升高,(7.74±3.07)μmol/Lvs(6.84±3.15)μmol/L,P=0.007;应用来氟米特者血清HCY水平无显著变化,(6.37±2.22)μmol/Lvs(6.43±2.38)μmol/L,P=0.739。结论 RA患者血清HCY水平升高,甲氨蝶呤治疗后进一步升高;血清ADP水平无明显变化。RA患者发生心血管疾病风险升高。

Expression of Homocysteine and Adiponectin in Rheumatoid Arthritis

Objective To study the expression of homocysteine （HCY） and adiponectin （ADP） in rheumatoid arthritis （RA）. Methods Serum levels of HCY and ADP were detected by enzyme linked immunosorbent assay（ELISA） in RA patients pre and post-treatment, and compared with normal controls and diabetes mellitus （DM） controls. Results The levels of HCY in the RA group were （6. 63 ±2. 75 ） μmoL/L, which were significantly higher than those of the normal controls （4. 30±2. 12） μmoL/L （P =0. 003）. The levels of HCY in the DM group were （6. 69±2. 98）μmol/L, and there was no statistical significant difference between RA group and DM controls （P 〉0. 05）. The levels of ADP in the RA group were （208. 12±74. 06）μg/L, which were lower than those of the normal controls （ 241.73 ±82. 05 ） μg/L and higher than DM controls （195.95 ±62. 03）μg/L, while there was no statistical significant difference in the three groups （P 〉0. 05）. After 6 months of treatment, the levels of HCY in the methotrexate treatment group was significantly increased （7.74±3.07）μmol/L vs （6. 84±3. 15 ）μmol/L, P = 0. 007, while there was no significant changes in the leflunomide treatment group （6. 37 ±2. 22）μmol/L vs （6. 43±2. 38）μmol/L, P =0. 739. Conclusion The level HCY is elevated in RA patients, and it is remarkably increased after treatment with methotrexate. The serum level of ADP has no significant changes. The risk of cardiovascular disease is high in RA patients.