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目的 探讨类风湿关节炎(RA)患者外周血及关节液中miR-132、miR-140-5p、miR-150及miR-181a的表达水平及其临床意义.方法 收集2016年1-12月本院收治的RA患者100例、骨关节炎(OA)患者64例及同期健康体检者64例,采集静脉血及关节液,分离血浆及外周血单个核细胞(PBMC);提取small RNA构建标准曲线;qRT-PCR检测miRNAs的表达量并进行相关性分析;并与类风湿因子(RF)、血沉(ESR)、C-反应蛋白(CRP)及抗环瓜氨酸肽抗体(ACCP)等疾病监测指标进行相关性分析.结果 相对于OA组、健康对照组,RA组miR-140-5p、miR-150、miR-181a在血浆、PBMC和关节液中表达上调;血浆中miR-132表达下调,而PBMC和关节液中miR-132表达上调(P<0.05).血浆、PBMC及关节液中miR-132、miR-140-5p、miR-150及miR-181a的表达存在一定程度的相关(P<0.05).RA患者miR-132、miR-140-5p、miR-150及miR-181a的表达水平与外周血RF、ESR、CRP和ACCP呈正相关(P<0.05).结论 RA患者血浆、PBMC及关节液中miR-132、miR-140-5p、miR-150及miR-181a的表达存在显著差异,其表达水平的改变可作为监测RA疾病活动的潜在有效指标,为RA临床诊断提供更为可靠地实验室检测依据.“,”Objective To investigate the expression of miR-132,miR-140-5p,miR-150 and miR-181a in peripheral blood and synovial fluid of patients with rheumatoid arthritis(RA)and its clinical significance. Methods 100 patients with RA were enrolled in our hospital from January to December in 2016,and 64 patients with osteoarthritis(OA)and 64 healthy subjects were collected. The venous blood and synovial fluid ,peripheral blood mononuclear cell(PBMC) and plasma samples were collected. The expression of miRNAs was detected by qRT-PCR ,and correlated with rheumatoid factor (RF),ESR,C-reactive protein(CRP)and anti-cyclic citrullinated peptide antibody(ACCP). Results Compared with OA group,the expression of miR-140-5p,miR-150 and miR-181a in the plasma,PBMC and synovial fluid of RA group were significantly increased;miR-132 was down regulated in plasma but upregulated in PBMC and synovial fluid(P<0.05). The expression levels of miR-132,miR-140-5p,miR-150 and miR-181a in plasma,PBMC and synovial fluid were correlated to some extent (P<0.05). The expression levels of miR-132,miR-140-5p,miR-150 and miR-181a in RA patients were positively correlated with peripheral blood RF,ESR,CRP and ACCP (P<0.05). Conclusions The expression levels of miR-132,miR-140-5p,miR-150 and miR-181a in plasma,PBMC and synovial fluid of RA patients were significantly different from those of osteoarthritis and healthy individuals,which indicated that they had important pathogenic effect in RA. Changes of these miRNA could be used as a potential effective indicator for monitoring the severity of RA disease ,and provide a more reliable laboratory test for RA diagnosis.