论文部分内容阅读
目的探讨幼年特发性关节炎(JIA)患儿血清IL-17及可溶性核因子(NF)-κB受体活化因子配体(sRANKL)变化的临床意义。方法采用ELISA法检测62例JIA活动期患儿(全身型24例、多关节型20例、少关节型18例)及26例年龄、性别无显著差异的健康儿童血清IL-17和sRANKL水平;抗风湿病治疗4～8周,采用同样方法复查患儿血清IL-17及sRANKL水平。结果活动期JIA患儿组血清IL-17水平高于健康对照组,差异均有统计学意义(P<0.05);其中全身型患儿血清IL-17水平稍高于健康对照组,差异无统计学意义(P>0.05);而多关节型及少关节型患儿血清IL-17水平均明显高于健康对照组,差异均有统计学意义(Pa<0.05)。活动期JIA患儿组血清sRANKL水平明显高于健康对照组,差异有统计学意义(P<0.05);其中全身型、多关节型及少关节型患儿血清sRANKL水平均明显高于健康对照组,差异均有统计学意义(Pa<0.05);多关节型及少关节型JIA患儿血清IL-17水平与血清sRANKL水平呈正相关(r=0.347、0.228,Pa<0.05)。抗风湿药物治疗4～8周复查,JIA活动期患儿血清IL-17及sRANKL水平均较治疗前明显下降,差异均有统计学意义(P<0.01,0.05),且伴有受累关节肿胀、压痛及活动受限明显改善。结论 IL-17及其诱导而产生的多种细胞因子具有较强的致炎性和具有强的诱导基质金属蛋白酶的作用;同时sRANKL则有促使破骨细胞产生的作用;血清IL-17和sRANKL测定是判定JIA患儿病情的重要生物学标志之一。
Objective To investigate the clinical significance of serum IL-17 and soluble nuclear factor-kappa B receptor ligand (sRANKL) in children with juvenile idiopathic arthritis (JIA). Methods Serum levels of IL-17 and sRANKL in 62 children with JIA active stage (24 cases of systemic type, 20 cases of multi-joint type, 18 cases of less joint type) and 26 cases of children with no significant difference in age and sex were detected by ELISA. Anti-rheumatic treatment for 4 to 8 weeks, using the same method to review children with serum IL-17 and sRANKL levels. Results The level of serum IL-17 in active JIA group was significantly higher than that in healthy control group (P <0.05). The level of serum IL-17 in systemic type children was slightly higher than that in healthy control group (P> 0.05). However, serum IL-17 levels in children with polyarticular and jointlessness were significantly higher than those in healthy controls (P <0.05). Serum levels of sRANKL in children with active JIA were significantly higher than those in healthy controls (P <0.05). The serum sRANKL levels in children with JIA were significantly higher than those in healthy controls (P <0.05). There was a positive correlation between serum IL-17 level and serum sRANKL levels in children with polyarticular and jointless JIA (r = 0.347, 0.228, Pa <0.05). Anti-rheumatic drug treatment for 4 to 8 weeks review, JIA activity in children with serum IL-17 and sRANKL levels were significantly lower than before treatment, the difference was statistically significant (P <0.01, 0.05), and associated with joint swelling, Tenderness and limited activity significantly improved. Conclusions IL-17 and many other cytokines induced by it are strongly inflammatory and have a strong effect of inducing matrix metalloproteinases. At the same time, sRANKL can promote the production of osteoclasts. Serum IL-17 and sRANKL Determination is to determine the JIA children one of the important biological signs of disease.