类风湿关节炎患者血清sTNF—R、TNF—α的变化

目的为探讨类风湿关节炎 (RA)与可溶性肿瘤坏死因子受体 (s TNF- R)、TNF- α、TNF- α/ s TNF- R比值的关系。方法应用双抗体夹心 EL ISA法检测了活动期 RA(2 8例 ) ,稳定期 RA (12例 )及健康人 (30例 )血清中 s TNF- R 、s TNF- R 、TNF-α的水平。结果活动期 RA患者血清 s TNF- R 、s TNF- R 、TNF-α水平明显高于健康人及稳定期 RA组 ,P均 <0 .0 1。稳定期 RA患者血清 s TNF- R 、s TNF- R 、TNF-α水平亦明显高于健康人 ,P<0 .0 1。在 RA患者中 ,血清 s TNF- R 、s TNF- R 水平与 ESR、CRP、Ritchie index呈显著正相关 ,与类风湿因子 (RF)水平无相关性。RA患者治疗 3个月后 s TNF- R 、s TNF- R 及 TNF- α/ s TNF R比值显著下降。结论 RA患者血清 s TNF- R 、s TNFR- 水平显著增高 ,且与疾病活动度呈正相关。测定血清 s TNF- R 、s TNF- R 、TNF- α/ s TNF- R水平可作为 RA诊断 ,监测疾病活动、治疗及判断预后的一项有意义的实验室指标

Changes of soluble tumor necrosis factor receptors,tumor necrosis factor alpha in rheumatoid arthritis

Objective　To investigate the relationship between soluble tumor necrosis factor receptors (sTNF-R), TNF-α, TNF-α/sTNF-R and rheumatoid arthritis. Methods　 Serum levels of sTNF-RⅠ, sTNF-RⅡ and TNF-αwere measured in 28 patients with active RA and 12 patients with inactive RA and 30 healthy controls, using double antibodies sandwiched ELISA. Results　The results showed that serum levels of sTNF-RⅠ, sTNF-R Ⅱ and TNF-α　were significantly higher in the group of patients with active RA than those　found　in healthy group and　in the patients with inactive RA. Serum levels of both sTNF-RⅠ, sTNF-RⅡ and TNF-α　were also significantly higher in patients with inactive RA than in healthy group(P＜0.01 for all). In RA, the serum concentrations of sTNF-RⅠ and sTNF-RⅡ were positively correlated with the levels of ESR，CRP，Ritchie index. Conclusions　These results suggest that the serum levels of sTNF-RⅠ and sTNF-RⅡwere significantly increased and positively correlated with the disease activity. The determination of serum levels of sTNF-RⅠ and sTNF-RⅡ can be regarded as a useful laboratory parameter for diagnosis of RA,monitoring of the disease activity and assessment of prognosis.