类风湿关节炎患者血清中白介素-32及趋化因子CXCL13水平的检测和临床意义

摘要

目的检测类风湿关节炎(RA)患者血清中白介素(IL)-32及趋化因子CXCL13的水平,以探讨其在RA中的意义。方法采用酶联免疫吸附试验(ELISA)法测定102例RA患者和50例正常对照者血清中 IL-32及趋化因子CXCL13水平。同时测定RA患者X线片分期、骨质破坏程度、关节压痛数、关节肿胀数、疾病活动度评分(DAS28)、红细胞沉降率( ESR)、C 反应蛋白( CRP)、抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)、肿瘤坏死因子(TNF)-α、IL-6等各种临床及炎症指标,进行相关性分析。结果RA患者血清中IL-32及趋化因子CXCL13水平明显高于正常对照者(P<0.05),且严重骨质破坏组 IL-32及趋化因子 CXCL13水平高于轻度或无骨质破坏组(P<0.05)；IL-32及趋化因子CXCL13水平均与RA患者X线片分期、骨质破坏程度、DAS28、ESR、CRP、CCP、TNF-α、IL-6呈正相关,且RA患者血清中 IL-32及趋化因子 CXCL13水平之间呈正相关( r =0.509,P=0.000),而与RA患者关节肿胀数、关节压痛数和血清中RF无相关性。结论RA患者血清中IL-32及趋化因子CXCL13与疾病活动度及相关炎症指标明显相关,提示IL-32及趋化因子CXCL13与RA存在密切联系,可作为RA判断病情及疾病活动的新指标。%Objective To measure the serum levels of IL-32 and chemokine CXCL13 in patients with rheumatoid arthritis and explore their clinical value. Methods The serum levels of IL-32 and chemokine CXCL13 were meas-ured by ELISA methods in 102 patients with RA and 50 healthy controls;analyzed the correlation among the IL-32, chemokine CXCL13 and the clinical data, inflammation maker of RA, such as X-ray stage, the bone destruction, the number of tender joints, the number of swollen joints, DAS28,ESR,CRP,CCP,RF,TNF-α,IL-6, etc. Results The serum levels of IL-32 and chemokine CXCL13 were significantly higher in RA patients than that in healthy controls(P<0.05). Moreover,the serum levels of IL-32 and chemokine CXCL13 those patients who had bone de-struction were higher than those with no or mild bone destructions(P<0.05);there was a positive correlation be-tween IL-32, chemokine CXCL13 and X-ray stage, the bone destruction, DAS28, ESR,CRP,CCP,TNF-α,IL-6. Especially, there was a positive correlation between IL-32 and chemokine CXCL13 (r=0.509,P=0.000). How-ever, there was no relationship with the number of swollen joints, tender joints, and RF. Conclusion The serum levels of IL-32 and chemokine CXCL13 were increased significantly,which was closly related with the disease activ-ity and inflammation maker. The results indicate that the abnormality of IL-32 and chemokine CXCL13 may be use-ful for the evaluation of disease activity and monitoring the progress of the disease.