类风湿关节炎患者不同阶段瘦素及瘦素受体系统水平的变化

摘要

目的：探讨瘦素及可溶性瘦素受体在类风湿关节炎患者血清中的变化规律。方法：选择女性类风湿关节炎患者88例，未治疗组40例，治疗后组48例；健康女性48例为正常对照组，用酶联免疫吸附方法检测瘦素、可溶性瘦素受体及抗环瓜氨酸肽抗体；用免疫比浊法测定C-反应蛋白。结果：与正常对照组比较，未治疗组类风湿关节炎患者血清瘦素水平显著增高（P<0.01），血清可溶性瘦素受体水平无显著变化（P＝0.05）。治疗后组与未治疗组比较，血清瘦素水平显著下降（P<0.01），可溶性瘦素受体水平显著提高（P<0.01）。治疗后组与正常对照组比较，血清瘦素水平显著下降（P<0.05），血清可溶性瘦素受体水平显著提高（P<0.01）。治疗前后血清瘦素与可溶性瘦素受体水平呈负相关（r值分别为-0.35，-0.319；P<0.05），未治疗组血清瘦素、可溶性瘦素受体与C-反应蛋白无相关（P>0.05），治疗后血清瘦素与C-反应蛋白正相关（r=0.358；P<0.05），治疗后瘦素水平与抗CCP抗体滴度呈正相关（r=0.343；P<0.05）。结论：类风湿关节炎患者治疗前后血清瘦素与可溶性瘦素受体水平均存在显著异常。通过对治疗前后瘦素与可溶性瘦素受体血清水平的分析，进一步认识类风湿关节炎的发病机制。%Objective:To explore the changes of leptin and soluble leptin receptor (sOB-R)in serum of patients with rheumatoid arthritis(RA).Methods:Three groups of female were enrolled:40 untreated and 48 treated with RA,and 48 health controls who have no significantly different body mass index(BMI)from those above.The leptin and soluble leptin receptor were measured by enzyme-linked immunosorbent assay.C-reactive protein was measured by immunoturbidimetry and the anti cyclic citrullinated peptide(CCP)antibody was measured by enzyme-linked immunoturbidimetry.Results:Compared with the health controls,the level of leptin in serum increased significantly(P<0.01)and the level of soluble leptin receptor in it had no significant change (P=0.05)in the untreated group.And in the treated group,the level of leptin decreased significantly(P<0.01) and the level of soluble leptin receptor increased significantly(P<0.01)compared with the health controls or the untreated group.Compared with the health controls,the level of leptin in serum significantly decreased(P<0.05) and the level of soluble leptin receptor increased obviously(P<0.01).There was a negative correlation between the level of leptin and that of the soluble leptin receptor before and after the treatment(r=-0.35,-0.319;P<0.05).In untreated group the levels of leptin and soluble leptin receptor had no correlation with C-reactive protein(P > 0.05). And in the treated group,the leptin had positive corelation with C-reactive protein(r=0.358;P<0.05)and so did the level of leptin with the anti cyclic citrullinated peptide(CCP)antibody(r=0.358,0.343;P<0.05).Conclusion:The levels of leptin and soluble leptin receptor were obviously different in patients with RA before and after the treatment.The pathogenesis of RA could be further known by analysis of the levels of leptin and soluble leptin receptor before and after treatment.