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通过检测类风湿关节炎(rheumatoid arthritis,RA)患者血清糖皮质激素诱导型肿瘤坏死因子受体配体(glucocorticoid-induced TNFR-related protein ligand,GITRL)水平,探讨在RA发病中的作用。实验采用双抗体夹心酶联免疫吸附试验(ELISA)测定RA患者(n=27)及健康人(n=23)血清GITRL的水平,分析血清中GITRL的含量与疾病临床表现和其他实验室检查结果之间的关系。结果显示RA患者血清中GITRL为6.08±4.61ng/ml,显著高于健康对照组血清中GITRL(0.38±0.29ng/ml,P<0.001)。进一步分析与RA活动的相关性,发现高疾病活动组(DAS28>5.1)的血清GITRL水平比中低活动组(DAS28<5.1)高两倍,差异具有统计学意义(P<0.05)。根据血清抗CCP抗体和类风湿因子水平分析,发现上述两种抗体阳性者患者血清的GITRL水平明显高于阴性型(P<0.05)。分析RA患者血清GITRL水平与临床和实验室指标的相关性,发现血清GITRL水平与晨僵时间、DAS28、血沉、C-反应蛋白呈正相关。由此我们得出结论RA患者外周血中GITRL水平增高,且与临床常用疾病活动指标呈正相关,提示测定血清GITRL水平具有作为监测RA疾病活动的潜在应用价值。
To investigate the role of glucocorticoid-induced TNFR-related protein ligand (GITRL) in the pathogenesis of RA by detecting the level of GITRL in patients with rheumatoid arthritis (RA). Serum levels of GITRL in patients with RA (n = 27) and healthy people (n = 23) were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The levels of serum GITRL and clinical manifestations and other laboratory findings The relationship between. The results showed that the serum GITRL of RA patients was 6.08 ± 4.61ng / ml, which was significantly higher than that of healthy controls (0.38 ± 0.29ng / ml, P <0.001). Further analysis of the association with RA activity found that serum GITRL levels were significantly higher in patients with high disease activity (DAS28> 5.1) than those in low and middle activity groups (DAS28 <5.1), with statistical significance (P <0.05). According to the level of serum anti-CCP and rheumatoid factor, the level of GITRL in the sera of patients with the above two antibodies was significantly higher than that of the negative (P <0.05). The correlation between serum GITRL levels and clinical and laboratory parameters was analyzed. The serum GITRL level was positively correlated with morning stiffness, DAS28, erythrocyte sedimentation rate and C-reactive protein. Therefore, we conclude that GITRL levels in peripheral blood of patients with RA are increased, and it is positively correlated with the activity index of common clinical diseases. It suggests that the determination of serum GITRL level has the potential value of monitoring the activity of RA disease.