血清、滑液中肿瘤坏死因子-α在痛风性关节炎中的表达及临床意义  

The expression and clinical significance of TNF-α in serum and synovial fluid in patients with gouty arthritis

作　　者：赖爱云[1] 徐健[1] 陶丽[1] LAI Aiyun;XU Jian;TAO Li(Department of Rheumatology and Immunology,First Affiliated Hospital of Kunming Medical University,Yunnan Province,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院风湿免疫科,云南昆明650032

出　　处：《中国医药导报》2018年第18期60-63,共4页China Medical Herald

基　　金：云南省卫生科技计划项目(2016NS051)

摘　　要：目的研究血清、滑液中肿瘤坏死因子-α(TNF-α)在痛风性关节炎(GA)中的表达及临床意义。方法选择2016年12月~2017年11月昆明医科大学第一附属医院收治的GA患者80例作为观察组,根据疾病严重程度分为观察1组(36例,重度)和观察2组(44例,轻度)两个亚组,均接受依托考昔+秋水仙碱治疗,另纳入同期60例健康体检者作为对照组。评估观察组治疗效果,检测三组血清和滑液中TNF-α的表达水平,比较治疗期间和不同疗效患者血清和滑液中TNF-α表达情况。结果临床治愈31例,显效24例,有效21例,无效4例,显效率为68.75%。入院时观察1组和观察2组血清和滑液TNF-α水平均显著高于对照组,差异均有统计学意义(P<0.05)。观察组中滑液TNF-α水平显著高于血清中TNF-α水平,差异有统计学意义(P<0.05)。治疗第10 d和2周时,观察1组和观察2组血清和滑液TNF-α水平均明显低于入院时,差异均有统计学意义(P<0.05)。显效组入院时和治疗2周时滑液TNF-α水平均显著低于非显效组,治疗2周时两组血清及滑液TNF-α水平均高于入院时,差异均有统计学意义(P<0.05)。结论 GA患者血清和滑液TNF-α水平显著高于健康者,监测患肢关节液TNF-α水平有助于评估治疗效果,指导临床干预。Objective To study the expression and clinical significance of tumor necrosis factor-α（TNF） in serum and synovial fluid in patients with gouty arthritis（GA）. Methods Eighty GA patients in First Affiliated Hospital of Kunming Medical University from December 2016 to November 2017 were selected as the observation group and then divided into two subgroups according to the severity of the disease： observation group 1（36 cases, severe） and observation group2（44 cases, mild）. Both were treated with colchicine and etoricoxib. Sixty healthy people were selected as the control group at the same time. The treatment outcome were record and the levels of TNF-α in serum and synovial fluid were detected in the three groups. The expression of TNF-α in serum and synovial fluid of patients with different therapeutic effects and during treatment were compared. Results Thirty-one cases were cured, 24 cases were markedly effective,21 cases were effective, 4 cases were ineffective, the markedly effective rate was 68.75%. The TNF-α levels of serum and synovial fluid in the observation group 1 and group 2 at admission were significantly higher than those of the control group, with statistically significant differences（P〈0.05）. The level of TNF-α in synovial was significantly higher than that of serum in the observation group（P〈0.05）. At the treatment of 10 d and 2 weeks, the TNF-α level in serum and synovial fluid in the observation group 1 and group 2 were significantly lower than those of admission（P〈0.05）. The TNF-α level in synovial fluid in the effective group were significantly lower than that of ineffective group at admission and 2 weeks after treatment; 2 weeks after treatment, the TNF-α level in serum and synovial fluid were all higher than those of admission, with statistically significant differences（P〈0.05）. Conclusion The level of TNF-α in serum and synovial from GA patients are significantly higher than healthy people. To monitor the level of TNF-α in the synovial fluid

关 键 词：痛风性关节炎 肿瘤坏死因子-Α 血清 滑液 

分 类 号：R589.7[医药卫生—内分泌]