类风湿关节炎患者血清触珠蛋白水平与疾病活动度及DMARDs治疗反应相关性分析  

High serum level of haptoglobin is associated with disease activity and the response of DMARDs therapy in rheumatoid arthritis patients

作　　者：王筱曦[1,2] 谈文峰[3] 张缪佳[3] 王芳[4] 冯小可[1,2] 张前德[1,2] 

机构地区：[1]南京医科大学中西医结合研究所,江苏南京210029 [2]南京医科大学第一附属医院中医科,江苏南京210029 [3]南京医科大学第一附属医院风湿科,江苏南京210029 [4]南京医科大学第一附属医院心脏科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2015年第6期844-848,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(30701129;30901332;81172845;81273294);国家中医药局青年科学基金(06-07JQ06);江苏省自然科学基金(BK2011851;BK2012875);教育部博士点基金(20093237110005);亚太风湿病联盟青年基金;国际风湿病联盟基金

摘　　要：目的 :探讨类风湿关节炎(rheumatoid arthritis,RA)患者血清触珠蛋白含量与疾病活动度及缓解病情抗风湿药(disease-modifying anti-rheumatic drugs,DMARDs)治疗的关系。方法 :选取67例基线期未接受过DMARDs治疗的活动性RA患者和27例健康志愿者作为正常对照,于DMARDs治疗12周前后分别以荧光实时定量PCR检测外周血单个核细胞(peripheral blood mononuclear cell,PBMCs)中触珠蛋白(haptoglobin,HP)m RNA表达,酶联免疫吸附测定血清HP含量,分析其与疾病活动度及治疗反应的相关性。结果:RA患者外周血PBMCs及血清中HP含量显著高于正常对照组(P<0.01),并与疾病活动度呈正相关。参照EULAR治疗反应标准,DMARDs治疗12周后,根据治疗前后DAS28评分下降是否≥1.2,将患者分为治疗有反应和无反应两组,结果显示12周DMARDs治疗无反应组RA患者基线血清HP水平明显高于有反应组(P<0.01),且治疗后无明显下降。结论:RA患者PBMCs及血清中HP水平显著升高,与疾病活动度呈正相关。基线血清HP含量与DMARDs治疗12周反应相关。Objective：To investigate whether serum levels of HP are associated with disease activity and the response of DMARDs therapy in the baseline rheumatoid arthritis （RA） patients. Methods： We selected 67 active RA patients who received no DMARDs in the baseline phase and 27 healthy volunteers. Clinical variables, levels of haptoglobin （HP） messenger RNA （mRNA） in peripheral blood mononuclear cells（PBMCs） and HP serum levels were measured at week 0 and week 12, and then, we analyzed the relationships between them. Results： The serum level of HP of RA patients was significantly higher than that of the healthy controls （P 〈 0.0001）, and positively correlated with the disease activity. After 12 weeks of DMARDs treatment, 55.22% of RA patients were categorized as responders according to European League Against Rheumatism （EULAR） response criteria （Disease Activity Score of 28 joints [ DAS28 ] decrease/〉 1.2） and 29.85% were defined as non-responders. The baseline HP in serum level from non-responders was significantly higher than those in responders（P 〈 0.01） and remained at high level in non-responders after 12 weeks DMARDs treatment. Conclusion： The mRNA in PBMCs and HP serum levels were significantly increased in RA patients and positively associated with RA disease activity. The HP serum levels of baseline of RA patients are correlated with the 12 weeks DMARDs therapy.

关 键 词：触珠蛋白 类风湿关节炎 DMARDS 

分 类 号：R593.22[医药卫生—内科学]