目的 探讨白介素1(IL-1)和促红细胞生成素(Epo)在类风湿关节炎(RA)伴发的慢性疾病性贫血(ACD)患者血清中的水平及意义.方法 采用酶联免疫吸附试验(ELISA)检测无贫血组、缺铁性贫血(IDA)组及ACD 组各20例患者血清中IL- 1及Epo水平,并与30例健康体检正常者(对照组)进行比较.结果 4组受检者IL-1、Epo、血红蛋白(Hb)、血浆铁蛋白(SF)、红细胞沉降率(ESR)比较,差异均有统计学意义(P＜0.05).其中无贫血组、对照组分别与ACD 组、IDA组比较IL-1、Epo、ESR明显降低,Hb、SF明显升高,差异均有统计学意义(P＜0.05);IDA组较ACD 组IL-1、SF、ESR明显降低,Epo水平明显升高,差异均有统计学意义(P＜0.05).IL-1与ESR呈正相关(r=0.64,P＜0.05);与SF呈负相关(r=-0.52,P＜0.05);与ACD 组的Hb呈负相关(r=-0.41,P＜0.05);与Epo无直线相关(r=-0.15,P＞0.05).结论 IL-1在RA伴ACD的发病过程中发挥着重要作用;RA伴ACD患者体内Epo水平相对不足,IL-1可能与影响铁代谢和Epo的生成有关.%To explore the levels and significance of interleukin - 1 ( IL - 1 ) and erythropoietin ( EPO ) in blood serum of patients suffered from Rheumatoid Arthritis ( HA ) combined with anemia of chronic disease ( ACD ). Methods ELISA method was used to detect the levels of IL - 1 and EPO in blood serum of HA patients without anemia group, RA patients combined with ACD group and RA patients combined with IDA group, with each group 20 cases. The results were compared with those of 30 healthy cases in control group. Results The levels of IL - 1 , Epo, Hb, SF and ESR showed statistically significant differences between the four groups ( P < 0. 05 ). The levels of IL - 1 , Epo and ESR in non - anemia group and control group were significantly lower than those of the RA - ACD group and RA - IDA group respectively, while the levels of Hb and SF were significantly higher respectively ( P < 0. 05 ). The levels of IL - 1 , SF and ESR in RA - IDA group were significantly lower than those of the RA - ACD group, while the level of Epo was significantly higher ( P < 0. 05 ). The level of IL - 1 was positively correlated with the level of ESR ( r = 0. 64, P < 0. 05 ), but were negatively correlated with the level of SF ( r = -0. 52, P<0. 05 ) and the level of Hb in RA - ACD group ( r= -0. 41 , P<0. 05 ). It showed no linear correlation with Epo ( r = -0.15, P>0.05). Conclusion IL - 1 plays an important role in the pathogenesis of RA - ACD. EPO is relatively insufficient in patients with RA - ACD. IL - 1 might be related to iron metabolism and the generation of EPO.
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