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目的探讨幼年类风湿关节炎(JRA)及类风湿关节炎(RA)患者IL-6、IL-8、sIL-2R和TNF-α等细胞因子(CK)水平的变化,及其与风湿活动的传统指标血沉(ESR)和C-反应蛋白(CRP)的相关性。方法采用夹心ELISA法，对30例JRA 和34例RA患者的血清中，4例JRA、7例RA、6例骨性关节炎(OA)和9例半月板损伤(MT)患者的关节液中IL-6、IL-8、sIL-2R和TNF-α的水平进行检测。结果①30例JRA 、34例RA患者血清IL-6和sIL-2R的水平与对照组相差非常显著(P∨0.01)；30例JRA 患者血清IL-8水平与对照组比较相差显著(P∨0.05)。②JRA全身型、少关节型患者血清IL-8、sIL-2R的水平和JRA多关节型患者血清IL-6的水平与对照组相差非常显著(P∨0.01)。③4例JRA及7例RA患者关节液sIL-2R的水平和RA患者关节液的IL-6水平与对照组相差显著(P∨0.05)。④JRA患者血清IL-6和sIL-2R的水平与ESR和CRP的变化呈明显的相关关系(r值分别为0.532和0.621)。结论①IL-6、sIL-2R的水平与JRA、RA病的活动性有关，是类风湿活动性的主要指标。②sIL-2R 不仅参与JRA和RA的全身病理损伤,而且是引起关节局部损伤的主要CK,IL-6也参与JRA 关节局部的病理损伤,在RA关节局部损伤似乎更为重要。③IL-8主要参与JRA的全身病理损伤,对关节局部病理损伤似乎并不重要。
Objective To investigate the changes of cytokines (IL-6, IL-8, sIL-2R and TNF-α) in juvenile rheumatoid arthritis (JRA) and rheumatoid arthritis (RA) The correlation between traditional indicators of ESR and C-reactive protein (CRP). Methods Sandwich ELISA was used to detect the serum levels of synovial fluid in 30 patients with JRA and 34 patients with RA, 4 patients with JRA, 7 patients with RA, 6 patients with osteoarthritis (OA) and 9 patients with meniscus injury (MT) IL-6, IL-8, sIL-2R and TNF-α levels were detected. Results ① The serum levels of IL-6 and sIL-2R in 30 JRA and 34 RA patients were significantly different from those in control group (P ∨ 0.01). The serum IL-8 levels in 30 JRA patients were significantly different from those in control group (P ∨ 0.05 ). ② The levels of IL-8 and sIL-2R in patients with JRA and less joint type were significantly different from those in control group (P ∨ 0.01). The level of sIL-2R in synovial fluid and the level of IL-6 in synovial fluid of 4 RA patients and RA patients were significantly different from those of control group (P ∨ 0.05). The levels of IL-6 and sIL-2R in patients with JRA were significantly correlated with the changes of ESR and CRP (r = 0.532 and 0.621, respectively). Conclusion ① The level of IL-6 and sIL-2R is related to the activity of JRA and RA, and is the main index of rheumatoid activity. (2) sIL-2R not only involved in the pathological injury of JRA and RA, but also was the main cause of local injury of joints. IL-6 also involved in the local pathological injury of JRA joints. Local injury in RA joints appeared to be more important. ③ IL-8 is mainly involved in the systemic pathological injury of JRA, it seems that the local pathological damage of joints is not important.