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【目的】运用多元统计分析的方法分析中医四诊信息与类风湿性关节炎(RA)细胞因子[白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)]、临床炎性检查指标[血沉(ESR)和C反应蛋白(CRP)]和临床免疫学检查指标[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、类风湿因子(RF)、补体C3]的相关性。【方法】随机选取符合纳入标准的早期RA女性患者70例,按RA证候问卷表采集患者各项证候信息,参照相应标准进行寒、热证候判断和活动性判断。同时,取患者晨起空腹血样,检测细胞因子(IL-8、TNF-α、IL-10)、临床炎性检查指标(ESR、CRP) 和临床免疫学检查指标(IgA、Ign、IgG、RF、C3)。采用因子分析方法对患者证候信息进行降维处理,然后采用典型相关分析方法探索各公因子与客观指标之间的相关性。【结果】将收集的中医四诊信息用因子分析得到5个公因子,他们分别能较好地反映关节局部病情以及中医寒证、热证、虚证的症状;除CRP外,早期女性RA患者各公因子的细胞因子(IL-8、 TNF-α、IL-10)、临床炎性检查指标(ESR)及各免疫学指标(IgA、IgM、IgG、RF、C3)均未见显著性差异。【结论】因子分析能够对症状进行分类研究,因子分析结果与传统证候分型有一致性;代表寒热证候的公因子CRP在早期RA患者之间有显著性差异,寒证的CRP低于热证,提示CRP可以作为RA寒热主观症状分类的微观指标之一;联合运用因子分析和典型相关分析方法分析主观症状与客观指标之间的相关性是可行的。
【Objective】 The objective of this study was to analyze the diagnostic value of four diagnostic methods of Chinese medicine and rheumatoid arthritis (RA) cytokines [interleukin 8 (IL-8), tumor necrosis factor α (TNF-α), interleukin 10 (IL-10)], clinical inflammatory markers [ESR and C-reactive protein (CRP)] and clinical immunological markers [IgA, IgM, Protein G (IgG), rheumatoid factor (RF), complement C3]. 【Methods】 Seventy patients with early RA were enrolled in this study. All the patients’ syndrome information was collected according to the RA syndrome questionnaire. The cold and heat syndromes and the activity judgment were judged according to the corresponding standards. At the same time, we took fasting blood samples from the morning, and detected the levels of IL-8, TNF-α, IL-10, ESR and CRP, IgA, , C3). Factor analysis was used to reduce the dimension of patient syndrome information, and then the correlation analysis between common factors and objective indicators was conducted by using the method of canonical correlation analysis. 【Results】 Five common factors were obtained by factor analysis of the four diagnostic information collected in TCM. They were able to reflect the local conditions of joints and symptoms of cold syndrome, heat syndrome and deficiency of traditional Chinese medicine. In addition to CRP, RA patients There were no significant differences in the levels of cytokines (IL-8, TNF-α, IL-10), clinical inflammatory markers (ESR) and various immunological parameters (IgA, IgM, IgG, RF, C3) . 【Conclusion】 Factor analysis can classify the symptoms. The result of factor analysis is consistent with the traditional syndrome classification. The common factor CRP representing cold and heat syndrome has significant difference in patients with early RA, and the CRP in cold syndrome is lower than Heat syndrome, suggesting that CRP can be used as one of the micro-indicators of sub-clinical symptoms of RA cold and heat; the combination of factor analysis and canonical correlation analysis method to analyze the correlation between subjective symptoms and objective indicators is feasible.