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目的检测可溶性尿激酶型纤溶酶原激活物受体(suPAR)在类风湿关节炎(RA)患者血浆和滑液中的含量,并结合临床资料和实验室指标分析其临床意义。方法采用酶联免疫吸附试验(ELISA)法分别检测了66例RA、23例骨关节炎(OA)和20名健康体检者的血浆,以及15例RA、9例OA患者滑液中suPAR的水平,比较不同病情活动组之间suPAR含量的变化,分析血浆和滑液中suPAR的含量与RA临床和实验室指标的相关性联系。同时观察其中16例RA患者治疗后血浆中suPAR的变化。结果RA患者血浆中suPAR的含量明显高于OA组和正常对照组(P均＜0．01),且血浆中suPAR水平随着RA病情活动程度的增强而增高。RA和OA滑液中suPAR水平均高于相应外周血水平(P＜0．01和P＜0．05),而RA滑液suPAR水平明显高于OA滑液(P＜0．01)。RA血浆和滑液中suPAR水平均与反映RA病情活动的指标如关节肿胀数、血沉(ESR)和C反应蛋白(CRP)呈正相关。治疗后RA患者血浆中suPAR水平明显下降(P＜0．05)。结论RA患者血浆和滑液中suPAR水平明显增高,提示其在RA病理过程中发挥重要作用,而且血浆suPAR水平与RA患者病情严重程度相关,可以作为判断RA病情活动的有效指标。
Objective To detect the content of soluble uPAR in human plasma and synovial fluid in patients with rheumatoid arthritis (RA) and analyze the clinical significance with clinical data and laboratory indexes. Methods The levels of suPAR in synovial fluid of 66 patients with RA, 23 patients with osteoarthritis (OA) and 20 healthy subjects and 15 patients with RA and 9 patients with OA were detected by enzyme linked immunosorbent assay (ELISA) The changes of suPAR levels in different disease groups were compared to analyze the correlation between the levels of suPAR in plasma and synovial fluid and the clinical and laboratory parameters of RA. At the same time, the change of suPAR in the plasma of 16 patients with RA was observed. Results The level of suPAR in plasma of RA patients was significantly higher than that of OA patients and normal controls (all P <0.01). The plasma suPAR level increased with the increase of RA activity. The levels of suPAR in RA and OA synovial fluid were higher than those in corresponding peripheral blood (P <0.01 and P <0.05), while the suPAR level in RA synovial fluid was significantly higher than that in OA synovial fluid (P <0.01). The levels of suPAR in RA plasma and synovial fluid were positively correlated with the indices of RA activity, such as joint swelling, ESR and C-reactive protein (CRP). After treatment, the level of suPAR in plasma of patients with RA was significantly decreased (P <0.05). Conclusions SuPAR levels in plasma and synovial fluid of RA patients are significantly increased, suggesting that RA plays an important role in the pathogenesis of RA. Moreover, the level of suPAR in plasma is correlated with the severity of RA and can be used as an effective index to judge the severity of RA.