目的 检测类风湿关节炎(RA)患者血清白介素(IL)-6、IL-17的水平变化,探讨其与系统损害及疾病活动度的关系.方法 收集RA患者124例及正常对照48例,ELISA法测定血清IL-6、IL-17水平.记录患者的一般情况、临床症状及各实验室指标,了解RA系统损害发生率及与疾病活动性关系,分析IL-6、IL-17与系统损害及疾病活动度的关系.结果 ① RA组与正常组相比,IL-6水平及IL-17水平显著升高(P<0.01);② 124例RA患者有系统损害85例(68.55%),其中心血管34例(27.42%),呼吸18例(14.52%),血液53例(42.74%),泌尿14例(11.29%),消化12例(9.68%),内分泌10例(8.06%),神经肌肉骨骼8例(6.45%);③ 有系统损害组较无系统损害组28关节疾病活动性(DAS28)、C反应蛋白(CRP)显著升高(P<0.01),IL-6、IL-17水平呈上升趋势,但差异无统计学意义.正规治疗的患者其DAS28及系统损害发生率较未正规治疗的患者显著降低(P<0.05);④ IL-6与IL-17分别与关节疼痛数、疼痛程度评分、血沉(ESR)、CRP等呈正相关性,与白蛋白等呈负相关性(P<0.05);二分类Logistic回归分析进一步显示IL-6与血小板增多有关,血沉与心律失常、贫血及血小板增多有关.结论 RA系统受累高达为68.55%,且与疾病活动有关,IL-6、IL-17与疾病活动度相关,IL-6与系统损害更为相关.%Objective To determine the serum levels of IL-6 and IL-17 and to explore its relationship with systemic damage and disease activity.Methods Serum IL-6 levels and IL-17 levels were measured by ELISA, and the relationship with disease activity or system involvement were analyzed.Results ① Serum levels of IL-6 and IL-17 were markedly higher in RA group than control group (P<0.01) .② The incidence rate of system impariment in RA was 68.55%, including cardiovascular 34 cases (27.42%), respiratory system 18 cases (14.52%), hematologic system 53 cases (42.74%), urinary system 14 cases (11.29%), digestive system12 cases (9.68%), endocrine system 10 cases (8.06%), nerve and skeletal system 8 cases (6.45%).③ The DAS28 and CRP levels showed higher level in patients with system impairment than without system impairment (P<0.01).Those patients who were received DMARDs standard treatment had lower incidence rate of system impairment than those without treatment (P<0.05).④ Positive correlation was detected between IL-6 or IL-17 levels and tender joint count, visual analogue scale scores of patients,erythrocyte sedimentation rate (ESR), C-reactive protein(CRP), and negative correlation was detected between IL-6 or IL-17 levels and albumin, respectively(P<0.05).Positive correlations were found between serum IL-6 and thrombocytosis, ESR and arhythmia, anemia and thrombocytosis invmultiple regression analysis.Conclusion The incidence rate of system impairment is 68.55%, and it is associated with disease activity.Serum IL-6 and IL-17 levels are correlated with disease activity and serum IL-6 level is correlated with system impairment.
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