类风湿关节炎患者血清IL-21及TGF-β的表达及临床意义

摘要

目的 探讨类风湿关节炎(RA)患者血清白介素-21(IL-21)及转化生长因子-β(TGF-β)的表达及临床意义.方法 选择2015年3月至2016年3月间新疆医科大学第一附属医院风湿免疫科诊治的30例RA患者为研究对象,以同期22例健康志愿者作为对照组,检测并比较RA组、RA活动期组和RA非活动期组患者与对照组受检者间的IL-21及TGF-β水平的差异,并分析RA患者IL-21及TGF-β水平与DAS28评分的相关性.结果 各组受检者间的IL-21、TGF-β水平及DSA28评分比较差异均有统计学意义(P<0.05),且RA组、RA活动组及RA非活动组患者的IL-21及DSA28评分水平明显高于对照组,TGF-β水平明显低于对照组,RA活动组IL-21及TGF-β水平改变较RA非活动组显著,差异均有统计学意义(P<0.05);RF-IgM、RF-IgA、RF-IgG、抗CCP抗体阳性患者的IL-21水平均明显高于阴性患者,TGF-β水平明显低于阴性患者,差异均有统计学意义(P<0.05);血清中IL-21水平与DAS28评分呈显著正相关(r=0.672,P<0.05),TGF-β水平与DAS28评分呈显著负相关性(r=-0.622,P<0.05).结论 RA患者体内IL-21显著升高,IGF-β显著降低,且其水平变化与患者病情存在密切关系.%Objective To investigate the expression and clinical significance of serum interleukin-21 (IL-21) and transforming growth factor-β(TGF-β) in patients with rheumatoid arthritis (RA). Methods A total of 30 patients with RA, who admitted to Department of Rheumatology and Immunology of the First Affiliated Hospital of Xinjiang Medical University from March 2015 to March 2016, were selected as the research objects. Meantime, 22 healthy volun-teers were enrolled as the control group. The differences of IL-21 and TGF-βlevels between patients with RA, RA ac-tive, RA inactive patients and control subjects were detected and compared. The correlation between IL-21 and TGF-βlevels and DAS28 score in patients with RA was analyzed. Results There were significant differences in the levels of IL-21, TGF-βand DSA28 between the four groups (P<0.05). The IL-21 level and DSA28 score in the RA group, RA ac-tivity group and RA inactive group was significantly higher than those in the control group, the level of TGF-βwas sig-nificantly lower than that in the control group, and the changes of IL-21 and TGF-βin the RA activity group were sig-nificantly higher than those in RA inactive group (all, P<0.05). The levels of IL-21 in patients with RF-IgM, RF-IgA, RF-IgG and anti CCP antibody were significantly higher than those in negative patients, and the level of TGF-βwas sig-nificantly lower than that of negative patients (P<0.05). Serum IL-21 level was positively correlated with DAS28 score (r=0.672, P<0.05), and serum TGF-βlevel showed a significant negative correlation with DAS28 score (r=-0.622, P<0.05). Conclusion IL-21 in patients with RA significantly increased, and TGF-β significantly reduced, which have close relationship with the patient's condition.