IL-27、RANKL在类风湿关节炎中的变化及其对骨质疏松的影响

发布时间：2018-02-12 13:46

本文关键词： 类风湿关节 IL-27 RANKL 骨密度骨质疏松　出处：《山西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:旨在通过测定RA患者血清中IL-27及RANKL的水平变化,并分析两者与疾病活动性指标的关系,并初步研究两者对RA患者骨质疏松的影响。方法:选择入住山西医科大学第一医院风湿免疫科,并明确诊断为RA的患者55例为试验组,均符合2010年ACR/EULAR的RA分类标准,同时符合相应入选及排除标准。并选择同时期于我院体检的年龄和性别相匹配的正常体检者42例作为对照组。清晨收集两组入选者空腹静脉血,尽快分离并保存血清。采用ELISA法测定两组血清中IL-27及RANKL水平,采用跟骨超声骨密度仪测定骨密度(BMD),进一步分析RA患者血清IL-27、RANKL水平的变化及两者与疾病活动性指标的关系,并探讨两者与骨质疏松间的联系。结果:1.与对照组相比较,RA组骨密度明显降低(P=0.004),且骨质疏松发生率为52.8%,明显高于对照组19.1%;2.RA组血清IL-27、RANKL及IL-27/RANKL比值,与对照组IL-27、RANKL及IL-27/RANKL比值相比均明显升高(P均㩳0.05);3.RA组中,IL-27、RANKL、IL-27/RANKL与反应疾病活动度指标(关节肿胀数、关节压痛数、血沉、抗CCP抗体、DAS28评分等)均无相关性(P均㧐0.05);4.RA组中IL-27、RANKL、IL-27/RANKL与骨密度均无相关性,且三者在骨质疏松、骨量减少、骨量正常三组中亦无明显差异(P均㧐0.05)。结论:1.RA患者的骨密度较正常人群是明显降低的,同时存在较高的骨质疏松发生;2.RA患者血清中IL-27、RANKL水平及IL-27/RANKL比值均明显升高,但与疾病活动性指标均无相关性,提示两者并不能反映疾病活动性;3.IL-27可能通过某种机制影响RA的骨代谢,具体机制有待进一步研究。
[Abstract]:Objective: to determine the changes of serum IL-27 and RANKL levels in RA patients, and to analyze the relationship between them and disease activity index. Methods: 55 patients who were admitted to the Department of Rheumatological Immunology in the first Hospital of Shanxi Medical University and 55 patients diagnosed as RA were selected as the experimental group. All of them were in accordance with the ACR/EULAR classification criteria of RA in 2010. At the same time, 42 cases of normal physical examination matched with age and sex in our hospital were selected as control group. Fasting venous blood was collected from two groups in the morning. Serum samples were isolated and preserved as soon as possible. Serum IL-27 and RANKL levels were measured by ELISA method, bone mineral density (BMD) was measured by calcaneal ultrasound absorptiometry. The changes of serum IL-27 RANKL levels and their relationship with disease activity in RA patients were further analyzed. Results compared with the control group, the bone mineral density of RA group was significantly lower than that of the control group, and the incidence of osteoporosis was 52.8, which was significantly higher than that of the control group 19.1and 2.RA, and the ratio of IL-27, RANKL and IL-27/RANKL was significantly higher than that of the control group, and the ratio of IL-27, RANKL and IL-27/RANKL in RA group was significantly higher than that in the control group. Compared with the control group, IL-27 RANKL and IL-27/RANKL ratio were significantly higher than that of the control group. In RA group, there was no correlation between IL-27, RANKL, IL-27 / RANKL and the index of disease activity (joint swelling, joint tenderness, erythrocyte sedimentation rate, anti CCP antibody DAS28 score, etc.). 4. In RA group, IL-27 RANKL / RANKL had no correlation with BMD, and there was no significant difference among the three groups in osteoporosis, decrease of bone mass and normal bone mass. Conclusion the bone mineral density of patients with RA is significantly lower than that of normal controls. There is also a higher incidence of osteoporosis. 2. The level of IL-27 RANKL and the ratio of IL-27/RANKL in patients with RA are significantly increased, but there is no correlation with the activity of the disease. These results suggest that IL-27 may not affect the bone metabolism of RA through some mechanism, and the specific mechanism needs further study.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R593.22

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