类风湿关节炎遗传多态性及NSAID药物临床疗效的研究  

Genetic polymorphism of rheumatoid arthritis and clinical efficacy of NSAID drugs

作　　者：刘瑞平[1,2] 赵公吟[1] 韩云芳[1] 张辉[1] 徐南伟[1] 

机构地区：[1]南京医科大学附属常州二院骨科,江苏常州213003 [2]南京医科大学附属常州二院,中心实验室,江苏常州213003

出　　处：《实用临床医药杂志》2011年第24期53-56,共4页Journal of Clinical Medicine in Practice

摘　　要：目的研究中国汉族人群中类风湿关节炎(RA)发生危险因素与环氧合酶2(COX-2)rs5275基因多态性的关系,以及非甾体抗炎药(NSAID)的临床疗效。方法采用以医院为基础的病例-对照研究,采用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)技术分析214例类风湿关节炎患者和478例对照COX-2 rs5275(8473 T>C)基因基因多态性,计算各种基因型的RA发生风险及其95%可信区间,其中60例的RA患者给予NSAID药物治疗,并随访治疗3个月后的疗效,根据治疗前后的DAS28评分,分析NSAID药物的疗效。结果 COX-2 rs5275基因多态3种基因型TT、TC、CC在RA组和对照组的频率分别为62.5%(TT)、32.7%(TC)、4.8%(CC)和67.5%(TT)、28.0%(TC)、4.5%(CC),Logistic回归发现与携带COX-2 rs5275 TT基因型的个体相比较,携带COX-2 rs5275 CC等位基因型与RA的发病风险无明显相关。60例RA患者药物治疗后的DAS28评分较治疗前有明显下降。结论 COX-2 rs5275基因多态性可能不是RA发生的危险因素,需要进一步研究证实,NSAID药物对RA疗效显著。Objective To explore genetic susceptibility of rheumatoid arthritis and the efficacy of NSAID therapy. Methods COX - 2 rs5275 genotypes were determined by matrix - assisted laser desorption/ionization time- of- flight mass spectrometry （MALDI- TOF MS） method in 214 rheuma- toid arthritis cases and 478 controls. 60 RA cases were treated with NSAID and followed - up after 3 months. DAS28 scores were compared before and after the treatment. Results The COX -2 rs5275 genotype frequencies were 62.5% （TT）, 32.7% （TC）, 4.8% （CC） in the rheumatoid arthritis group and 67.5% （TT）, 28.0% （TC）, 4.5% （CC） in the control group respectively. Logistic regression analyses revealed that the risk associated with COX -2 rs5275 variant genotype was 1.17 for COX -2 rs5275 CC compared with its wild -type homozygote. DAS28 scores decreased significantly in 60 RA patients after NSAID treatment. Conclusion COX -2 rs5275 polymorphism may not serve as a risk factor of rheumatoid arthritis susceptibility. Further functional studies are warranted to verify our find- ings. NSAID is a valuable therapy in RA. KEY WORDS： rheumatoid arthritis; matrix -assisted laser desorption/ionization time -of- flight mass spectrometry; single nucleotide polymorphism; NSAID

关 键 词：RA 基质辅助激光解吸电离飞行时间质谱 单核苷酸多态性 NSAID 

分 类 号：R593.22[医药卫生—内科学] R394-4[医药卫生—临床医学]