类风湿关节炎患者滑液和血浆中尿激酶型纤溶酶原激活物及其受体测定的临床意义

目的 检测尿激酶型纤溶酶原激活物（uPA）及其受体uPAR在类风湿关节炎（RA）患者滑液和血浆中的含量，并结合临床和实验室资料分析其实际意义。方法 运用酶联免疫吸附法（ELISA）双抗体夹心法分别测定46例RA、8例骨关节炎（OA）和12名健康对照个体的血浆以及15例RA患者滑液中的uPA和uPAR含量，同时将类风湿因子阳性（RF^ ）和阴性（RF^-）组之间uPA和uPAR含量进行比较，并采用直线相关与回归方法分析血浆和滑膜中uPA、uPAR的含量与相评价RA病情活动指标之间的相互关系。结果 RA患者滑液中uPA、uPAR的含量均显著高于其自身血浆（P＜0．001，P＜0．01）；RA血浆中uPA、uPAR的含量又明显高于OA组（P＜0．05，P＜0．0001）和正常对照组（P＜0．0001，P＜0．001)；RF^ 和RF^-组之间uPA、uPAR在滑液和血浆中的含量差异均无显著性（P＞0．05）。RA滑液和血浆中uPA、uPAR在滑液和血浆中的含量差异均无显著性（P＞0．05）。RA滑液和血浆中uPA、uPAR的含量还与反映RA病情活动的指标C反应蛋白（CRP）和类风湿因子（RF）之间均呈正相关；RA滑液中uPA、uPAR的含量还与关节肿胀个正相关。结论 RA患者滑液和血浆中uPA和uPAR的含量是反映RA病情活动的有用指标，提示uPA和uPAR基因可能通过降解细胞外基质的蛋白裂解作用参与RA的免疫作用机制并发挥重要作用。

Detection and significance of urokinase-type plasminogen activator and its receptor in synovial fluid and plasma in rheumatoid arthritis

Objective To measure the levels of urokinase type plasminogen activator (uPA) and its receptor (uPAR) in synovial fluid and plasma of patients with RA and investigate its clinical significance.Methods By using ELISA sandwich method,the levels of uPA and uPAR in plasma from 46 patients with RA and 8 with osteoarthritis (OA) were measured.Those in synovial fluid (SF) from 14 patients with RA,and plasma from 12 healthy subjects were measured as controls.Results The concentration of uPA and uPAR in SF from patients was significant higher than that in their plasma ( P <0 001, P <0 01),and the concentration of uPA and uPAR in plasma of RA was also much higher than that in plasma of OA patients ( P <0 05, P <0 000 1) and healthy subjects ( P <0 000 1, P <0 001).There was no significance between plasma levels of RF + and RF - in RA patients.The concentration of uPA and uPAR of plasma in RA correlated positively with CRP,RF and the number of swelling joints.Conclusion The levels of uPA and uPAR in SF and plasma are useful parameters for monitoring disease activity of RA.These findings suggest that the uPA and uPAR genes may play an important role via proteolytic damage of the extracellular matrix during the development of RA.