类风湿关节炎患者血清血管内皮细胞生长因子测定及临床意义

目的　了解类风湿关节炎 (RA)患者血清血管内皮细胞生长因子 (VEGF)与病情活动性的相关性以探讨其临床意义。方法　采用酶联免疫吸附试验 (ELISA)方法检测RA患者活动组 (30例 )、缓解组 (30例 )及正常对照组 (30名 )的血清VEGF ,并分析血清VEGF与RA病情活动指标之间的关系。结果　活动组RA患者血清VEGF(183± 5 6 )ng L显著高于缓解组 (84± 8)ng L及正常对照组 (82± 8)ng L (P <0 0 1) ;活动组患者血清VEGF浓度与RA病情活动指标C反应蛋白 (CRP) (r=0 711,P <0 0 0 1)及Stoke指数 (r=0 6 38,P <0 0 0 1)呈显著正相关 ,与类风湿因子 (RF) (r=0 16 1,P >0 0 5 )、血沉 (ESR) (r=0 12 8,P >0 0 5 )、双足双手X线狭窄侵蚀积分 (r=- 0 0 11,P >0 0 5 ;r=0 0 2 4 ,P >0 0 0 5 )无相关性。与反应RA活动期指标血清透明质酸 (HA)、可溶性白细胞介素 2受体 (sIL 2R)、白细胞介素 2 (IL 2 )相比 ,VEGF判断RA活动期的敏感性为 93 3% ,特异性为 93 3%。结论　血清VEGF与RA的病情活动性有关 ,检测血清VEGF有助于RA活动性判断

The clinical significance of determining serum vascular endothelial growth factor in patients with rheumatoid arthritis

Objective To investigate the clinical significance of the detection of vascular endothelial growth factor (VEGF) in rheumatoid arthritis (RA).Methods The serum level of VEGF in patients with RA in active or clinically remissive period and normal controls was determined by ELISA,and the correlation between VEGF and RA disease active index was analyzed.Results The serum level of VEGF in patients with the active period of RA (183±56) ng/L was significantly higher than that in patients with clinical remission of RA (84±8) ng/L and in normal controls (82±8) ng/L ( P <0 01).The serum level of VEGF correlated significantly with C reactive protein (CRP) ( r =0 711, P <0 001) and Stoke index ( r =0 638, P <0 001),but did not correlate with rheumatoid factor (RF) titer ( r =0 161, P >0 05),ESR ( r =0 128, P >0 05) and radiologic score ( r =-0 011, P >0 05; r =0 024, P >0 05) in patients with the active period of RA.The sensitivity and specificity of VEGF in detecting the activity of RA were 93 3% and 93 3%,being fairly higher compared with hyaluronic acid (HA),interleukin 2 (IL 2) and soluble IL 2 receptor (sIL 2R).Conclusion VEGF correlates with the activity of RA disease and the measurement of serum level VEGF is a noninvasive and useful method for monitoring the disease activity of RA.