sICAM-1和Th1／Th2型细胞因子在类风湿关节炎发病中的作用

目的探讨类风湿关节炎（RA）患者外周血血清中人可溶性细胞间黏附分子1（sICAM-1）的浓度和Th1／Th2极性偏移的关系以及与临床的相关性。方法用ELISA法检测32例RA患者和25例正常人外周血血清中sICAM-1、Th1细胞分泌的细胞因子IFN-γ和Th2细胞分泌的细胞因子IL—10的浓度，以IFN-γ／IL-10比值直接反映Th1／Th2极性偏移状态，并作差异性比较，进一步分析sICAM-1与Th1／Th2极性偏移及疾病活动度的相关性。结果（1）RA活动期组血清sICAM-1和IFN-γ浓度水平显著高于RA稳定期组和正常对照组，而IL-10的水平则显著低于RA稳定期组和正常对照组，差异均具有统计学意义（P〈0．05）；（2）RA稳定期组和正常对照组血清中sICAM-1、IFN-γ及IL-10的浓度水平无显著差异性（P〉0．05）；（3）RA活动期组sICAM-1浓度水平与IFN-γ、IL-10浓度水平及INF-γ／IL-10比值之间存在明显的相关性（rl=0．815，r2=0．739，r3=0．681）；（4）RA活动期组血清中sICAM-1浓度水平与DAS28呈明显正相关（相关系数r=0．833，P〈0．01）。结论RA患者外周血血清中存在着高水平的sICAM-1，Th1/Th2细胞因子的表达水平存在明显失衡，并发现其分泌模式是朝着r11｜11细胞偏移，表现为Th1型细胞因子处于相对优势，由此证实RA患者血清中sICAM-1的异常升高与Th1／Th2细胞因子的表达失衡存在一定的相关性，共同参与了RA的发病。

The Role of slCAM-1 and Th1/Th2 Cytokines in the Pathogenesis of Rheumatoid Arthritis

Objective To evaluate rheumatoid arthritis of human peripheral blood serum soluble intercellular adhesion molecule 1 （sICAM-1） levels and the relationship between Th1/Th2 shift and the polarity between the disease and the role of the development process and clinical relevance. Methods The ELISA method detected 32 cases of RA patients and 25 normal peripheral blood serum sICAM-1,Thl cells secrete the cytokine IFN-γ, and Th2 cells secrete the cytokine IL-10 concentration to IFN-γ / IL-10 directly reflect the ratio of Thl/Th2 polar shift state,and compared for differences,and further analysis of sICAM-1 and Thl/Th2 polar shift and the correlation of disease activity. Results （1）RA activity of serum sICAM-1 and IFN-γ levels were significantly higher than in stable RA group and normal control group,while the levels of IL-10 was significantly lower than the stable group and the normal control group, the difference were statistically significant （P〈O.05）. （2）RA stable group and control group in serum sICAM-1, IFN-γ and IL-10 concentration levels were not significantly different（P〉0.05）. （3）RA active group sICAM-1 levels and IFN-5, ,IL-10 levels and the ratio INF-γ/IL-10 significant correlation between（r1=0.815,r2=0.739,r3=0.681）. （4）RA in active phase serum levels of sICAM-1 concentration was positively correlated with the DAS28 （correlation coefficient r=-0.833,P〈0.01）. Conclusion RA patients there are high levels of serum sICAM-1, Th1/Th2 cytokine imbalance in the expression level of obvious, and found that secretion patterns shift towards Th1 cells, Th1-type cytokines showed a relatively advantage, which confirmed that RA patients with serum sICAM-1 increased and abnormal expression of Th1/Th2 cytokine imbalance there is a certain correlation to participate in the pathogenesis of RA.