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目的通过对类风湿关节炎(RA)患者血清可溶性CD44v5(sCD44v5)水平的检测,分析sCD44v5与RA疾病活动性的关系,探讨其在RA发病及病情判断中的价值。方法研究对象分为:RA活动组35例,RA缓解组、骨关节炎(OA)对照组、强直性脊柱炎(AS)对照组、健康对照组,各31例。对RA活动组中20例患者给予来氟米特治疗3个月,同时记录所有RA患者的临床及实验室指标。采用ELISA法检测患者血清sCD44v5,对比组间及RA治疗前后血清sCD44v5水平的差异,并分析其与RA各项指标间的相关性。结果RA活动组的血清sCD44v5的水平明显高于RA缓解组、OA对照组、AS对照组、健康对照组;RA缓解组、OA对照组、AS对照组的血清sCD44v5的水平高于健康对照组,差异均具有统计学意义(P<0.05)。血清sCD44v5的水平与患者的疼痛评分、晨僵时间、关节压痛数和关节肿胀数、关节压痛和关节肿胀指数、健康评价(HAQ)、疾病活动性评分(DAS)、类风湿因子(RF)、血沉(ESR)、C反应蛋白(CRP)具有正相关性,而与年龄、病程和抗环瓜氨酸多肽(ACCP)抗体无相关性。20例活动性的RA患者给予来氟米特治疗3个月后症状及活动性指标好转,治疗后血清sCD44v5水平较治疗前下降,差异具有统计学意义(P<0.01)。结论CD44v5可能参与了RA疾病的发生、发展,血清sCD44v5水平在一定程度上能反映RA病情的活动性。
Objective To investigate the relationship between sCD44v5 and the activity of RA in patients with rheumatoid arthritis (RA) and to explore the value of sCD44v5 in the pathogenesis of RA. Methods The subjects were divided into RA active group (n = 35), RA remission group, osteoarthritis (OA) control group, ankylosing spondylitis (AS) control group and healthy control group, with 31 cases in each group. Twenty patients in the RA activity group were treated with leflunomide for 3 months, and clinical and laboratory parameters were recorded for all RA patients. Serum levels of sCD44v5 were measured by ELISA. The serum levels of sCD44v5 in control group and RA group were compared before and after treatment. The correlations between serum sCD44v5 level and RA were also analyzed. Results The level of serum sCD44v5 in RA active group was significantly higher than that in RA remission group, OA control group, AS control group and healthy control group. The serum sCD44v5 level in RA remission group, OA control group and AS control group was higher than that in healthy control group, The differences were statistically significant (P <0.05). Serum sCD44v5 levels correlated with patient pain scores, morning stiffness time, joint tenderness and joint swelling, joint tenderness and joint swelling index, health assessment (HAQ), disease activity score (DAS), rheumatoid factor (RF) Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were positively correlated with age, duration of disease and anti-cyclic citrullinated peptide (ACCP) antibody. Twenty patients with active RA received leflunomide for 3 months. The symptoms and activity of leflunomide improved after treatment. The serum sCD44v5 level decreased after treatment (P <0.01). Conclusion CD44v5 may be involved in the pathogenesis and progression of RA disease. The level of serum sCD44v5 may reflect the activity of RA in a certain extent.