类风湿关节炎患者血清白细胞介素及肿瘤坏死因子表达的研究  

Study on the expression of interleukins and tumor necrosis factor in serum of patients with rheumatoid arthritis

作　　者：施利青 董婷[1] 甸自金[1] 欧阳红梅[1] 

机构地区：[1]云南省第一人民医院检验科,云南昆明650034 [2]大理州永平县人民医院检验科,云南大理672600

出　　处：《国际检验医学杂志》2015年第23期3416-3417,3420,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨不同时期类风湿关节炎(RA)患者体内炎性细胞因子的变化,研究RA患者随病程进展机体内部免疫微环境的改变。方法采用流式细胞术微球阵列法检测活动期(36例)、缓解期(23例)RA患者及体检健康者(对照组,30例)血清白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-1β(IL-1β)及肿瘤坏死因子(TNF)的表达水平。结果活动期RA患者IL-6、IL-1β及TNF水平高于对照组和缓解期组,IL-4和IL-10水平低于对照组和缓解期组,差异均有统计学意义(P<0.05);缓解期RA患者IL-6和IL-1β水平高于对照组,差异均有统计学意义(P<0.05),而IL-4、IL-10和TNF与对照组比较差异无统计学意义(P>0.05)。除IL-6随病程发展在后期趋于稳定外,其他4类炎性细胞因子中,IL-4、IL-10有上升趋势,IL-1β和TNF有下降趋势。结论活动期RA患者血清Th1及Th2型细胞因子存在失衡状态,以向Th1型因子偏移为主;将RA按病程划分定期检测炎性细胞因子水平,可为评价病情活动度提供可靠的依据。Objective To explore the changes of inflammatory factors in patients with different stage of rheumatoid arthritis（RA）,and to study the changes of immune microenvironment in patients with RA.Methods The serum levels of tumor necrosis factor（TNF）,interleukin-10（IL-10）,interleukin-6（IL-6）,interleukin-1β（IL-1β）and interleukin-4（IL-4）in patients with RA on active stage（36 cases）,patients with RA on remitting stage and healthy individuals（30 cases）were detected by using cytometric bead array.Results The serum levels of IL-6,IL-1β and TNF in active stage RA group were higher than those in control group and remitting stage RA group,while serum levels of IL-4 and IL-10 were lower than those in control group and remitting stage RA group,and the differences were statistically significant（P〈0.05）.The serum levels of IL-6and IL-1β in remitting stage RA group were significantly higher than those in control group（P〈0.05）.There were no significant differences in levels of IL-4,IL-10 and TNF between remitting stage RA group and control group（P〈0.05）.As the disease develops,except for IL-6 which tended to be stable,the serum levels of IL-4 and IL-10 had a rising trend,while serum levels of IL-1β and TNF had a downward trend with the progression of RA.Conclusion There is an imbalance between Th1 and Th2 cytokines in patients with RA on active stage,in which Th1 cytokines are dominantly expressed.Periodic detection of inflammatory factors according to the course of RA could provide a reliable basis for the assessment of disease activity.

关 键 词：类风湿关节炎 流式细胞术 流式细胞术微球阵列法 白细胞介素 肿瘤坏死因子 

分 类 号：R593.22[医药卫生—内科学] R446.1[医药卫生—临床医学]