类风湿关节炎患者血清铁调素与骨形态发生蛋白6的变化及临床意义  

Changes of serum hepcidin and bone morphogenetic protein-6 in patients with rheumatoid arthritis and the clinical significance

作　　者：邬秀娣[1] 陈勇[1] 张振[1] 谢斌华[1] 黄娴倩[1] 干敏芝[1] 李霞[2] 孙凌云[2] 

机构地区：[1]浙江省宁波市第二医院风湿免疫科,315010 [2]南京大学医学院附属鼓楼医院风湿免疫科

出　　处：《中华风湿病学杂志》2013年第11期729-733,共5页Chinese Journal of Rheumatology

基　　金：浙江省宁波市自然科学基金（2013A610265）

摘　　要：目的 探讨血清铁调素和骨形态发生蛋白（BMP）-6在类风湿关节炎（RA）患者中的水平变化及其临床意义.方法 采用酶联免疫吸附法测定99例RA患者、40例其他结缔组织病患者（CTD组）、40名健康志愿者的血清铁调素、BMP-6浓度及RA患者的白细胞介素（IL）-6、IL-1β、肿瘤坏死因子（TNF）-α,并检测类风湿因子（RF）水平及其他临床指标,比较3组间铁调素、BMP-6的差异；同时比较RA患者中不同疾病活动度（DAS28）评分组间、血清铁调素浓度升高组与正常组间的铁调素、BMP-6及各临床指标及细胞因子水平的差异,并分析血清铁调素及BMP-6水平与其他因素间的相关性.组间比较采用t检验或Mann-Whithey U检验,相关分析采用Spearman相关分析.结果 血清铁调素和BMP-6浓度在RA患者中[分别为（9.9±9.3）、（0.48±0.45） ng/ml]明显升高,与CTD组[分别为（3.8±1.3）、（0.32±0.27） ng/ml]和健康对照组[分别为（3.6±1.8）、（0.20±0.18） ng/ml]比较,其差异均有统计学意义（P＜0.05）；铁调素及BMP-6在DAS28评分＞5.1的RA疾病高度活动组中较DAS28评分≤5.1的非高度活动组明显升高,其差异均有统计学意义（P＜0.05）,而血红蛋白浓度在疾病高度活动组中明显低于非高度活动组（P＜0.01）；46例RA患者血清铁调素升高,其BMP-6、IL-6浓度及DAS28评分均高于铁调素正常组（P＜0.05）；RA患者的血清铁调素水平与BMP-6、IL-6、RF、DAS28呈正相关（r=0.376,0.298,0.264,0.267；P均＜0.05）,而BMP-6也与IL-6、TNF-α、RF、DAS28呈正相关（r=0.237,0.263,0.539,0.249；P均＜0.05）.结论 推测铁调素、BMP-6和IL-6是RA中同一信号通路上的相关炎症因子,共同参与了RA的炎症反应；血清铁调素及BMP-6水平可能可以作为RA疾病活动性评价指标.Objective To investigate the changes of serum hepcidin （Hepc） and bone morphogenetic protein （BMP）-6 in patients with rheumatoid arthritis （RA）,and the clinical significance.Methods Blood samples from 99 patients with RA,40 patients with other connective tissue diseases （CTD） and 40 healthy controls were measured by enzyme linked immunosorbent assay （ELISA）.The levels of serum Hepc,BMP-6,interleukin （IL）-6,IL-1β,tumor necrosis factor （TNF）-α,rheumatoid factor （RF） and their correlations with disease activity score for 28 joints （DAS28） and other clinical factors were analyzed by SPSS software.Differences between groups were analyzed using the t test or Mann-Whitney U test.Corrnelations were evaluated with Spearman＇s correlation test.Results Both levels of Serum Hepc and BMP-6 were found to be higher in patients with RA [（9.9±9.3）,（0.48±0.45） ng/ml respectively] than in the patients with other CTD [（3.8± 1.3）,（0.32±0.27） ng/ml respectively] and healthy controls [（3.6±1.8）,（0.20±0.18） ng/ml respectively）] （P＜0.05）.The level of hemoglobin in patients with RA and high DAS28 scores （＞5.1） was found to be lower than in patients with RA and low DAS28 scores （≤5.1） （P＜0.01）.On other hand,the levels of Hepc and BMP-6 were higher in patients with high DAS28 scores than patients with lower DAS28 score （P＜0.05）.Fortysix RA patients had a high level of serum Hepc; the DAS28 scores and the levels of BMP-6 and IL-6 were all found to be higher in RA patients with high serum Hepc level than in the patients with normal serum Hepc level （P＜0.05）.In patients with RA,the level of serum Hepc was positively correlated with BMP-6,IL-6,RF and DAS28 scores （r=0.376,0.298,0.264,0.267 respectively,P＜0.05）.And the level of serum BMP-6 was positively correlated with IL-6,TNF-α,RF and DAS28 scores （r=0.237,0.263,0.539,0.249 respectively,P＜0.05）.Conclusion Hepc,BMP-6 and IL-6 are the related inflammatory factors in the same s

关 键 词：关节炎 类风湿 骨形态发生蛋白质类 铁调素 疾病活动性 

分 类 号：R593.22[医药卫生—内科学]