类风湿关节炎患者血清白细胞介素6、白细胞介素17、粒细胞-巨噬细胞集落刺激因子和肿瘤坏死因子α水平检测的临床意义  

Clinical significance of detection of serum IL -6,IL -17,GM -CSF and TNF -αlevels in patients with rheumatoid arthritis

作　　者：王丽[1] 

机构地区：[1]昆山市中医医院肺病科,江苏省昆山215300

出　　处：《中国基层医药》2016年第16期2454-2457,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨血清白细胞介素6（IL-6）、白细胞介素17（IL-17）、粒细胞-巨噬细胞集落刺激因子（GM-CSF）和肿瘤坏死因子α（TNF-α）水平检测在类风湿关节炎患者中的临床意义。方法回顾性分析79例类风湿关节炎患者临床资料，按活动性分为稳定期和活动期，另选取40例健康体检者作为对照组，比较各组对象血清 IL-6、IL-17、GM-CSF 和 TNF-α水平，并探讨其相关性。结果活动期患者 CRP、ESR 和 DAS28[39．14（35．81）mg／L，41．92（33．27）mg／L，4．85（2．74）]高于稳定期患者[21．07（16．53）mg／L，29．57（25．14）mg／L，2．88（1．76）]及对照组[5．92（2．80）mg／L，3．19（2．24）mg／L]，差异均有统计学意义（F ＝7．013、6．224、2．136， P ＜0．05）。活动期患者 GM-CSF、TNF-α及 IL-6血清水平[33．81（26．97）pg／mL，47．23（42．81）pg／mL，75．35（41．69）pg／mL]高于对照组[6．19（5．11）pg／mL，4．68（5．21）pg／mL，33．18（20．94）pg／mL]及稳定期患者[12．81（9．76）pg／mL，8．46（10．37）pg／mL，43．05（38．14）pg／mL]，差异均有统计学意义（F ＝5．328、6．117、8．016，P ＜0．05）。而 IL-17组间差异无统计学意义（F ＝0．776，P ＞0．05）。IL17与 DAS28、GM-CSF 及 IL-6无相关性（r ＝0．213、0．167、0．316，P ＞0．05），TNF-α与 DAS28、GM-CSF、IL-6及 IL-17（r ＝0．761、0．729、0．549、0．421，均 P ＜0．05）、IL-6与 DAS28和 GM-CSF（r ＝0．648、0．626，均 P ＜0．05）、GM-CSF 与 DAS28均有良好相关性（r ＝0．563，P ＜0．05）。结论 IL-6、GM-CSF 及 TNF-α与类风湿关节炎的病情进展有明显正相关性，联合检测对监测病情有重要价值。Objective To investigate the clinical significance of detection of serum IL -6,IL -17, GM-CSF and TNF -αlevels in patients with rheumatoid arthritis.Methods A retrospective research was made in 79 cases with rheumatoid arthritis,and they were divided into stable period and active period,and another 40 healthy persons were chosen as control group.IL -6,IL -17,GM-CSF and TNF -αlevels were compared,and the relevance was investigated.Results CRP,ESR and DAS28 of active period [39.14 （35.81 ）mg/L,41.92 （33.27）mg/L, 4.85（2.74）]were higher than those of the stable period[21.07（16.53）mg/L,29.57（25.14）mg/L,2.88（1.76）] and control group[5.92（2.80）mg/L,3.19（2.24）mg/L],the differences were statistically significant （F =7.013, 6.224,2.136,all P 〈0.05）.Serum levels of GM-CSF,IL -6 and TNF -αof active period[33.81（26.97）pg/mL, 47.23（42.81 ）pg/mL,75.35 （41.69 ）pg/mL]were higher than those of control group [6.19 （5.11 ）pg/mL, 4.68（5.21）pg/mL,33.18 （20.94）pg/mL]and stable period [12.81 （9.76 ）pg/mL,8.46 （10.37 ）pg/mL, 43.05（38.14）pg/mL],the differences were statistically significant （F =5.328,6.117,8.016,all P 〈0.05）.And there was no significant difference in IL -17 level between the groups （F =0.776,P 〉0.05）.No correlation was observed between IL17 and DAS28,GM-CSF and IL -6 （r =0.213,0.167,0.316,all P 〉0.05）,TNF -αand DAS28,GM-CSF,IL -6 and IL -17 （r =0.761,0.729,0.549,0.421,all P 〈0.05 ）,IL -6 and DAS28 andGM-CSF （r =0.648,0.626,all P 〈0.05）,GM-CSF and DAS28 had good correlation （r =0.563,P 〈0.05）. Conclusion IL -6,GM-CSF and TNF -αlevels were positively correlated with the progression of rheumatoid arthritis,joint detection is of great value in monitoring the disease.

关 键 词：关节炎 类风湿 白细胞介素 6 白细胞介素 17 粒细胞-巨噬细胞集落刺激因子 肿瘤坏死因子 α 

分 类 号：R593.22[医药卫生—内科学]