类风湿关节炎患者外周血Th17细胞、血清IL-17和IL-6检测水平与疾病活动性的研究

【作者】 王鑫博；

【导师】 李小峰；

【作者基本信息】 山西医科大学 ， 内科学， 2010， 硕士

【摘要】 第一部分：Th1 7细胞亚群的测定在类风湿关节炎患者不同活动期变化的研究目的：1.应用流式细胞仪检测类风湿关节炎(reuhmatoid arthritis, RA)患者外周血Thl7细胞水平。2.探讨RA患者外周血Th17细胞水平的检测,在判断疾病活动程度中的可能作用。方法：1.采用流式细胞仪检测63例次诊断明确的RA患者、15例健康对照者外周血Th17细胞水平。2.将63例次RA患者按照DAS28评分分为高、中、低活动组,并初步探讨Th17细胞水平的测定在RA患者不同病情活动程度中意义。结果：1.RA患者与健康对照者相比,外周血Th17水平前者明显高于后者。2.按照DAS28评分分组,高、中、低活动组的RA患者与健康对照者外周血Th17细胞水平存在组间差异,高活动组外周血Th17细胞水平明显高于健康对照组,余组间比较,无明显差异。3.以双手X线分级分组,同样与健康对照组进行多变量组间比较,各组间Th17细胞水平无明显差异。结论：运用流式细胞仪,通过对患者外周血进行Th17细胞检测,可监测患者病情,对患者病情活动严重程度进行评估。第二部分：CBA方法测定类风湿关节炎患者血清I L-17、I L-6表达水平目的：通过检测RA患者血清中白介素17(interleukin 17)与白介素6(interleukin 6)表达水平,分析其在RA不同活动期变化的意义。方法：1.流式细胞仪微球捕获芯片技术CBA (Cytometric Bead Array)测定63例次(IL-6为62例次)RA患者和18例健康对照者血清IL-17、IL-6表达水平。2.按照DAS28评分分组,高、中、低活动组的RA患者与健康对照者血清IL-17、IL-6水平进行多组变量组间比较。结果：1.RA患者与健康对照者相比,血清IL-17、IL-6水平前者明显高于后者。2.按照DAS28评分分组,高、中、低活动组的RA患者与健康对照者外周血IL-17水平存在组间差异,高活动组外周血Th17细胞水平明显高于健康对照组,余组间比较,无明显差异；IL-6水平在各组间无明显差异。3.以双手X线分级分组,同样与健康对照组进行多变量组间比较,各组间IL-17水平无明显差异。结论：RA患者血清中的IL-17和IL-6与健康人存在明显差异,联合Th17细胞的检测可作为预测RA疾病进展及病情活动的潜在生物学标志物。更多还原

【Abstract】 PartⅠ:Determination of Th17 cell subsets in patients of rheumatoid arthritis at different Period of activityObjictive:Detected by flow cytometry with rheumatoid arthritis peripheral the level of blood Th17cells.Methods:1.63 patients’ which were diagnosed as RA and 15 healthy controls’Th17 cells were detected by flow cytometry.2.63 patients of RA were divided into high, medium and low activity group in accordance with DAS28 scores, which did multiple comparison with healthy control group. Preliminary study the level of Th17 cells in the determination of disease activity in RA patients with different levels of significance.Results:1.The level of Th17 cells of the patients which were diagnosed as RA is higher than healthy controls.2. The level of Th17 cells is higher in high activity group than in healthy control group. There is no significant difference between other groups.3. There is no significant difference between these groups which were divided by X-ray film of both hands.Conclusion:We can monitor patient’s condition by testing Th17 cells in peripheral blood from patients with flow cytometry, and evaluate the severity of disease activity of patients. PartⅡ:The expression of IL-17 and IL-6 in serum of patients with rheumatoid arthritis by CBAObjective:Analyze the significance of IL-17 and IL-6 in various activities period of patients with RA by detecting their expression in serum of patients.Methods:1. Determine IL-17 and IL-6 in serum of 63 RA patients and 18 healthy controls by Cytometric Bead Array(CBA).2.63 patients of RA were divided into high, medium and low activity group in accordance with DAS28 scores, which did multiple comparison of their expression of IL-17 and IL-6 with healthy control group.Results:1. The level of IL-17 and IL-6 of the patients which were diagnosed as RA is higher than healthy controls.2. The level of IL-17 is higher in high activity group than in healthy control group. There is no significant difference between other groups. There is no significant difference in IL-6 between all groups.3. There is no significant difference between these groups which were divided by X-ray film of both hands.Conclusion:There is significant difference in serum of IL-17 and IL-6 between RA patients and healthy people. Join in detection of Th17 cells in RA may predict disease progression and determine disease activity by these biomarkers.更多还原