| Rheumatoid arthritis ( RA) is a heterogenous disease, which is characterized by symmetrical multiarthritis in clinic and is a progressive invasive autoimmune disease with systemic vasculitis usually. At prsent, studies have proved RA has obvious relationship with the net of immune regulation. As pre - inflammatory factors, TNF - acan increase the functions of neutrophils and eosinophils and make them produce superoxide and release Lyososome, inducing expression of other cellular factors and inflammatory factors. TNF - ais one of important nosogenetic factors of RA. Insulin - like Growth Factor - 1 (IGF - 1) is a kind of polypeptid, which has similar structure to insulinogen. It plays an important role in development, differentiation and metabolism of cells. Recently, some studies had make sure that IGF - 1 and IGF-2 expressed in different develop stage of many tissue cells. In vivo, IGF ?1 receptors almost exists all of immune cells, which reflects on stimulation of IGF - 1, So it conferred that IGF - 1 played some kind of role in RA, especially in the patients with systemic pathological changes. This experiment examined serum IGF - 1 and TNF - a in RA by ELISA and analyzed the relationship between them and other indexes, approached the role of them in RA, especially with systematic pathological changes and offered some new thoughtfulness for posting the pathogeny and exploiting new therapeutic means of RA.MethodSelected 39RA patients, divided them into high -platelet group and normal - platelet group according to the amount of platelets in pe-ripherol blood. Selected 20 healthy people as control group, age and gender have no difference from patients group. The patients in experimental group were sampled 3ml vein blood of limosis in early morning, collected super serum after centrifugation and keeped in ?0^ in refrigeratory and measuring in the same term. At the same time, examined liver function, blood routine, erythrocyte sedimentation rate, immunoglobulins, coagulant three items, protein electrophoresis et al and analyzed by ELISA. Experimental data was dealed with SPSS and done t ?test and relativity analysis. Its results were expressed by x±s.Results1. Serum level of IGF - 1 in RA patients is 102. 66 ±83. 85ng/ ml, 37.46 ±74. 08ng/ml in control. IGF - 1 in RA group was higher than that of control group ( p = 0. 005 < 0. 01). In RA group, IGF - 1 in high - platelet group was higher than that of normal - platelet group (p = 0. 03 < 0. 05 ) and control group ( p < 0. 01). There is no obvious difference between normal ?platelet group and control group.2. serum TNF - am RA group is 1. 15 ±0. 43ng/ml, which is greatly higher than that of control group (0. 27 ±0. 10ng/ml) ,p < 0.01. In RA group, serum TNF - aand IGF - 1 showed an remarkably positive correlation, r = 0. 521 p = 0. 001 < 0. 01.3. In the analysis of other relative indexes in RA group, serum IGF - 1 had relationship with prothrombin time, serum TNF - a, ESR, amount of platelet and a.2 - globulin showed a positive correlation . 34 patients were examined by X - ray chest in RA group. 13 of them proved to be pulmonary interstitial pathological changes 38. 2% , IGF- 1 in them is 155. 4 ±98. 50ng/ml and compared with control group,p = 0. 001 < 0. 01; TNF - am them was 1. 22 ± 0. 57ng/ml, compared with control group p =0.003 <0.01.4. RA patients were divided into two groups according to the course of disease; one group was less than 2 years, the anthor was more than 2 years. Serum level of IGF - 1 in short - course group was greatly higher than that of the other group, p =0. 029 <0. 05, which was statistical difference.DisscussionRA is an autoimmune disease, which is multisystem inflammation involved peripheral arthritis and systemic vaculitis often influenced its prognosis. At the present, we have known that many cellular factors took part in pathological process of RA, TNF - awas studied more widely, called pre - inflammatory factors and was vital cellular factors to start inflammatory reaction, play...
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