类风湿关节炎患者血清血管内皮生长因子血管生成素-1和2的检测及其与关节滑膜病变的相关性研究  

Measurement of serum vascular endothelial growth factor, angiopoietin-1 and angiopoietin-2 in patientswith rheumatoid arthritis and the correlation with synovial lesions

作　　者：黄娴倩[1] 陈勇[1] 陈立斌[2] 龚丽敏[3] 谢斌华[1] 彭勇[1] 黄华[4] 忻霞菲[4] 邬秀娣[1] 张振[1] 

机构地区：[1]浙江省宁波市第二医院风湿免疫科,315010 [2]浙江省宁波市第一医院超声科 [3]浙江省宁波市第一医院检验科 [4]浙江省宁波市第一医院风湿免疫科

出　　处：《中华风湿病学杂志》2012年第10期679-683,共5页Chinese Journal of Rheumatology

摘　　要：目的检测类风湿关节炎（RA）患者血清血管内皮生长因子（VEGF）、血管生成素-Ⅰ（Ang-1）与Ang-2的水平，分析各组间的差异及其与超声评估关节滑膜病变的相关性。方法采用酶联免疫吸附试验（ELISA）检测82例RA患者，21名健康者，24例骨关节炎患者血清中VEGF、Ang-1和Ang-2的水平，RA患者根据疾病活动评分（DAS28）确定活动组与稳定组，活动组中再根据病程分为早期活动组及中晚期活动组，其中早期活动组28例，中晚期活动组32例，稳定组22例，同期超声扫查29例RA患者28个关节，记录滑膜厚度指标[滑膜增厚的关节数（USiointcountSH）、滑膜增厚积分（USindexSH）]、关节积液指标[关节积液的关节数（USjointcountSF）、关节积液积分（USindexSF）]、血流信号[采集到能量信号的关节数（USiointcountPD）、能量多普勒评分（TSS）]及滑膜动脉阻力指数（RI值），分析三者与RA关节超声检查关节滑膜病变的相关性，并分析三者间血清水平相关性。另外检测25例活动期患者经治疗3个月后血清中3个因子的水平，对比组间血清VEGF、Ang-1、Ang-2水平、红细胞沉降率（ESR）、C反应蛋白（CRP）及DAS28差异。组间比较采用单因素方差分析，治疗前后比较采用Wilcoxon检验，相关性分析采用直线回归或Spearman秩相关。结果RA组的血清VEGF，Ang-1水平[（1285±272）Dg／ml，（0．55±0．25）ng／m1]高于骨关节炎组[（934±80）pg／ml，（0．32±0．16）ng／ml]及健康对照组[（565±115）pg／ml，（0．24±0．21）ng／ml]，RA组的血清Ang-2水平[（1．36±0．40）ng／m1]高于健康对照组[（0．52±0．32）ng/mal]．RA早期活动组血清VEGF水平[（1355±194）pg／ml]高于中晚期活动组[（1096±477）pg／ml]和稳定期组[（862±91）pg／ml]，RA早期活动组、中晚期活动组和稳定组间血清Ang-1水平差异无统计学意义，RA稳定期组血清Ang-2水平[�Objective To evaluate the clinical significance of serum level of vascular endothelial growth factor （VEGF）, angiopoietin （Ang）-1 and Ang-2 in patients with rheumatoid arthritis （RA）. Methods Serum levels of VEGF, Ang-1 and Ang-2 were measured with enzyme linked immunosorbent assay （ELISA）. Twenty-one healthy subjects, 24 osteoarthritis patients and 82 rheumatoid arthritis patients were included. We defined active and inactive group according to RA disease active score, while early active RA and late active RA group were defined on the basis of disease course. There were 28 early active patients, 32 late active patients and 22 inactive patients with rheumatoid arthritis. At the same time 29 RA patients were examined with ultrasound. Synovial hypertrophy （US joint count SH, US index SH）, synovial fluid（US joint count SF, US index SF）, resistance index and power Doppler signal （US joint PD, TSS） were scored. The correlation was analyzed. We also detected the serum levels of VEGF, Ang-1, Ang-2, ESR, CRP and DAS28 in 25 patients with active RA after 3 month regular treatment. We used one-way ANOVA to compare the differences between groups, and Wilcoxon test to compare the differences between before and after treatment. We analyzed the correlation with linear correlation or Spearman rank test. Results The serum level of VEGF [（1285±272） pg/ml], Ang-1 [（0.55±0.25）ng/ml] in patients with rheumatoid arthritis were higher than osteoarthritis patients [ （934±80） pg/ml, （0.32±0.16） ng/ml ] and normal controls [ （565 ± 115 ） pg/ml, （0.24± 0.21） ng/ml], and the serum level of Ang-2 [ （1.36±0.40） ng/ml] was higher than normal controls [ （0.52± 0.32） ng/ml]. The serum level of VEGF [（1355±194） pg/ml] in early active patients was higher than late active patients [（1096±477） pg/ml] and inactive patients [（862±91） pg/ml]. The serum level of Ang-1 in early active patients, late active patients and inactive patients with rheumatoid arthritis had no st

关 键 词：血管内皮生长因子类 血管生成素Ⅰ 血管生成素Ⅱ 关节炎 类风湿 超声检查 

分 类 号：R593.22[医药卫生—内科学]