中文摘要：

目的探讨类风湿关节炎（rheumatoid arthritis,RA）患者的疾病活动性与炎症相关因子的关系。方法收集363例住院和门诊RA患者的血清及临床数据,包括血沉（ESR）、C反应蛋白（CRP）、血小板计数（PLT）及类风湿因子（RF）,ELISA检测抗环瓜氨酸肽抗体（CCP）、葡萄糖6磷酸异构酶（GPI）、肿瘤坏死因子-α（TNF-α）及白细胞介素-1β（IL-1β）的表达,按DAS28（ESR）分为疾病高活动及中低活动组,分析PLT、TNF-α及IL-1β在RA疾病高、中低活动组与正常对照组之间的差异,探讨其与临床各指标的相关性。结果 RA疾病高活动组PLT水平明显高于中低活动与正常对照组（P=0.000）。3组间TNF-α、IL-1β计量值分布有显著差异（P〈0.05）。根据平均秩次推断,RA疾病高活动组TNF-α、IL-1β中位数分别为[2.97（1.87,13.53）、0.95（0.55,5.47）]pg/ml,中低活动组中位数分别为[2.78（1.91,8.18）、0.72（0.57,5.14）]pg/ml,均显著高于正常对照组（P〈0.01）,而高活动组与中低活动组之间TNF-α或IL-1β比较计量值分布无统计学差异。PLT与关节压痛数、关节肿胀数、晨僵、VAS、DAS28（4）、CRP及ESR均呈显著正相关（P〈0.01）,而TNF-α与关节压痛数、VAS、DAS28（4）及ESR呈正相关（P〈0.05）,IL-1β仅与ESR相关（r=0.179,P=0.001）。PLT、TNF-α及IL-1β均与CCP、RF、GPI无相关性（P〉0.05）。结论 PLT及TNF-α可作为RA疾病活动度的灵敏指标之一,IL-1β在一定程度上反应炎症活动程度。

英文摘要：

Objective To investigate the correlation between disease activity and the levels of inflammatory factors including blood platelet,tumor necrosis factor-α（TNF-α）,and interleukin-1β（IL-1β） in rheumatoid arthritis（RA） patients.Methods Laboratory indexes including erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP） level,platelet count（PLT）,and rheumatoid factor（RF） level of 363 RA patients were collected by conventional method.The expression of anti-cyclic citrullinated peptides（anti-CCP）,glucose-6-phosphate isomerase（GPI）,TNF-α,and IL-1β in serum was determined by ELISA.The RA patients were divided into high-disease activity group and moderate/low-disease activity group according to their DAS28（4） ESR scores.The differences between the two groups and a control group in terms of PLT,TNF-α and IL-1β were analyzed to explore the correlation between disease activity and clinical indexes.Results The PLT in the high-disease activity group was significantly higher than those in the moderate/low-disease activity group and control group（P=0.000）.There were significant differences among the three groups in terms of TNF-α and IL-1β level distributions（P0.05）.According to mean rank order,the medians of TNF-α and IL-1β levels were [2.97（1.87,13.53）] pg/ml and [0.95（0.55,5.47）] pg/ml in high-disease activity group and [2.78（1.91,8.18）] pg/ml and [0.72（0.57,5.14）] pg/ml in moderate/low-disease activity group,both higher than those in control group（P0.01）.There was no significant difference between high-disease activity group and moderate/low-disease activity group in terms of TNF-α and IL-1β level distributions.PLT had positive correlations with tender joint counts,swelling joint counts,morning stiffness,VAS,DAS28（4） ESR,CRP,and ESR（P0.01）.TNF-α had positive correlations with tender joint counts,VAS,DAS28（4） ESR,and ESR（P0.05）.IL-1β had positive correlation with ESR（r=0.179,P=0.001） only.None of PLT,TNF-α,and IL-1β wa