D-二聚体、白介素-6、肿瘤坏死因子-α与类风湿关节炎活动性关系分析  

Analysis of activity relationship between D-dimer,interleukin-6,tumor necrosis factor-αand rheumatoid arthritis

作　　者：任通 朱芸[2] 桑雨婷 许蕾 REN Tong;ZHU Yun;SANG Yuting;XU Lei(School of Clinical Medicine,Weifang Medical University,Weifang261000,China;Department of Rheumatology and Immunology,Weifang People's Hospital,Weifang261000,China)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261000 [2]山东省潍坊市人民医院风湿免疫科,山东潍坊261000

出　　处：《中国现代医生》2020年第4期1-4,共4页China Modern Doctor

摘　　要：目的探讨类风湿关节炎(RA)患者外周血D-二聚体(D-D)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平变化与疾病活动度的相关性及D-D对RA发病过程的意义。方法选取潍坊市人民医院2017年8月~2018年12月门诊及住院197例RA患者,根据28个关节疾病活动度评分(DAS28)将患者分为低度活动组51例、中度活动组65例、高度活动组81例;同期选取健康体检者50例为对照组。观察各组外周血D-D、IL-6、TNF-α水平变化及与DAS28的相关性比较分析,同时分析与类风湿因子(RF)、C反应蛋白(CRP)、红细胞沉降率(ESR)关联性。结果RA组与对照组比较D-D、IL-6、TNF-α均明显增高,差异有统计学意义(P<0.05)。中度活动组和重度活动组与对照组及低度活动组比较D-D均增高(P<0.05)。RA组D-D、IL-6分别与RF、ESR、CRP、DAS28呈正相关关系(P<0.05),TNF-α与RF、DAS28呈正相关关系(P<0.05)。结论RA组D-D、IL-6、TNF-α与DAS28呈正相关性,所以D-D可作为RA患者病情活动性的评估指标之一,提示RA患者疾病发展过程中体内有高凝-纤溶系统异常活动,故抗凝治疗可作为RA治疗的依据。Objective To investigate the correlation between changes of D-dimer(D-D),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels in peripheral blood of patients and disease activity of rheumatoid arthritis(RA)and the significance of D-D on the pathogenesis of RA.Methods A total of 197 RA patients in Weifang People's Hospital from August 2017 to December 2018 were enrolled.According to 28 joint disease activity scores(DAS28),the patients were divided into low activity group(51 cases),moderate activity group(65 cases)and high-activity group(81 cases).In the same period,50 healthy subjects were selected as the control group.The correlation between the changes of D-D,IL-6 and TNF-αlevels in peripheral blood and DAS28 in each group was observed,and the correlation of rheumatoid factor(RF),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)was analyzed.Results D-D,IL-6 and TNF-αwere significantly increased in the RA group compared with those of the control group,and the difference was statistically significant(P<0.05).The D-D of the moderate activity group and the high activity group was higher than that of the control group and the low activity group(P<0.05).There were positive correlations of D-D and IL-6 and RF,ESR,CRP and DAS28(P<0.05).TNF-αwas positively correlated with RF and DAS28(P<0.05).Conclusion D-D,IL-6 and TNF-αin RA group are positively correlated with DAS28,so D-D can be used as one of the evaluation indexes of RA patients'disease activity.It is suggested that patients with RA have abnormal activity of hypercoagulant-fibrinolytic system during the development of the disease,so anticoagulant therapy can be used as the basis for RA treatment.

关 键 词：类风湿关节炎 D-二聚体 白介素-6 肿瘤坏死因子-Α 

分 类 号：R593.22[医药卫生—内科学]