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目的研究核因子-κB(NF-κB)在难治性全身型幼年特发性关节炎(SOJIA)发病机制中的作用。方法收集难治性SO-JIA患儿(难治性SOJIA组)活动期9例、非难治性SOJIA患儿(非难治性SOJIA组)活动期11例和对照组儿童9例作为研究对象。通过免疫磁珠分离出抗凝血中单核细胞,提取其核蛋白。采用凝胶迁移实验法检测其NF-κB的表达水平;并以ELISA法检测其外周血血清TNF-α的表达水平。结果 1.NF-κB在3组中表达水平差异有统计学意义(F=5.887,P<0.05)。NF-κB在难治性SOJIA组表达最高(35.01±14.78),与非难治性SOJIA组(23.48±11.52)和对照组(17.43±3.62)两两比较差异均有统计学意义(Pa<0.05)。2.TNF-α水平在3组中表达水平差异有统计学意义(F=51.701,P<0.001)。TNF-α在难治性SOJIA组表达最高[(30.38±3.21)ng.L-1],与非难治性SOJIA组[(18.13±3.31)ng.L-1]和对照组[(16.60±2.98)ng.L-1]两两比较差异均有统计学意义(Pa<0.05)。3.SOJIA患儿外周血单核细胞核内NF-κB与外周血血清TNF-α水平呈正相关(r=0.464,P<0.05),但与PLT、ESR、CRP、单核细胞计数等指标无相关性。结论难治性SOJIA患儿体内存在高表达的NF-κB和TNF-α,且这些因子对于维持炎症的持续发展具有重要意义。NF-κB在临床上或许可以作为SOJIA患儿病情严重程度的预测指标之一。
Objective To investigate the role of nuclear factor-κB (NF-κB) in the pathogenesis of refractory systemic juvenile idiopathic arthritis (SOJIA). Methods Nine children with refractory SOJIA (refractory SOJIA group), 9 active children with non-refractory SOJIA (non-refractory SOJIA) and 9 children with control were enrolled in this study. Antithrombin monocytes were isolated by immunomagnetic beads and their nuclear proteins were extracted. The expression of NF-κB was detected by gel shift assay. The level of TNF-α in serum was detected by ELISA. The expression of NF-κB in the three groups showed significant difference (F = 5.887, P <0.05). The expression of NF-κB in the refractory SOJIA group was the highest (35.01 ± 14.78), there was significant difference between the non-refractory SOJIA group (23.48 ± 11.52) and the control group (17.43 ± 3.62) (P <0.05) . There was significant difference in the level of TNF-α between the three groups (F = 51.701, P <0.001). TNF-α was highest in refractory SOJIA group [(30.38 ± 3.21) ng.L-1], but not in refractory SOJIA group [(18.13 ± 3.31) ng.L-1] and [16.60 ± 2.98 ) ng.L-1], the difference was statistically significant (Pa <0.05). There was a positive correlation between NF-κB in peripheral blood mononuclear cells and TNF-α in peripheral blood in children with SOJIA (r = 0.464, P <0.05), but no correlation with PLT, ESR, CRP and monocyte count Sex. Conclusion There are high expression of NF-κB and TNF-α in children with refractory SOJIA, and these factors are of great significance in maintaining the sustained development of inflammation. NF-κB may be clinically one of the predictors of the severity of illness in children with SOJIA.