| Rheumatoid arthritis(RA) is a common difficult and baffling diseases in clinic, it is a chronic and progressive autoimmune disease(AID). Its etiology is unknown so far,and may be associated with heredity, endocrine, geography, occupation, nutrition, bacteria and virus infection,and psychological and social environment difference factors.The main clinical manifestations of RA include chronic, symmetry and many synovial arthritis and the extra-articular changes. Clinically, the disease occurs in the hand, wrist, feet and other small joints,it attacks recurrently and shows symmetric distribution.In the early stage，joint manifests swelling and pain,then articular cartilage is damaged and joint space narrows down,in the late stage, serious bone destruction and absorption lead to joint rigidity, deformity, dysfunction.The disease shows poor prognosis and has a high probability of disability.Clinically,the judgment of pathological changes degree and activities of RA has great significance for the diagnosis and treatment and prognosis.All the time, the evaluation indictor,which evaluates early diagnosis and disease severity of RA,is the research hotspot problem.At present,the disease activity evaluation of RA needs to comprehensive judgment by many factors in clinic,such as the number of joint swelling,pain and tenderness joint number,morning stiffness time, C-reaction protein (CRP), erythrocyte sedimentation rate(ESR) and so on,disease activity score(DAS) rating system is currently the most widely used evaluation standard among the evaluation standards. In recent years, with the continuous improvement of instrument and inspection technique, the measurement of inflammation marker is also more and more be taken seriously,Clinicians hope to find more sensitive and specific inflammation marker, in order to provide better service for clinic.Clq as the promoter of complement classic activation pathway, it plays an important role in preventing tissue autoimmune injury and clearing circulating immune complexes in vivo.At present, the research about Clq is mainly concentrated in patients with systemic lupus erythematosus,but in patients with RA is rarely founded. Serum amyloid A protein(SAA) is an acute phase protein, belongs to heterogeneous class protein of the apolipoprotein family, its relative molecular weight is about12000. In the acute phase reaction, SAA content increased sharply, the research found that serum amyloid A protein is most closely related to disease activity in the case of suffering from inflammatory arthritis. Related studies have shown that elevated serum SAA levels in patients with RA, and better reflect the activity of RA. However, the role of SAA in the pathogenesis of RA is not clear, so it needs to continue to discuss. RA is a chronic immune-mediated inflammatory diseases, its inflammation and tissue injury involves a variety of inflammatory cytokines, abnormal expression of various inflammatory factors play an important role in the progression of RA. The study found that lnterleukin-6(IL-6) is mainly produced by activated monocytes. It is one of the important mediators of synovial inflammation and joint injury of RA. Related studies have shown that IL-6levels increase in serum of patients with with RA in active stage, and is related to some indicators of disease activity. Therefore, this study intends to detect C1q,SAA and IL-6levels of different periods in the serum of patients with RA, and compares their levels with that of the normal control group,in order to investigate clinical significance of changes of the three levels of different periods in patients with RA.Materials and Methods1. Clinical data and methods We collect50blood specimens of patients with RA in active stage and inactive stage respectively, all the RA patients fulfilled the American College of Rheumatology (ARA) revised criteria for classification in1987, and we also collect30healthy human blood specimens, then store them at-80℃refrigerator after centrifugation, our purpose is to detect Clq, SAA and IL-6levels in serum of the three groups.We use Roche P-800automatic biochemical analyzer produced by Germany Roche and Clq reagent produced by Shanghai Beijia biochemical reagent Co, Ltd to detect serum C1q levels by immunoturbidimetric assay(ITA).We use Roche cobas8000automatic biochemical analyzer and IL-6reagent produced by Germany Roche to detect serum IL-6levels by electro chemiluminescence(ECL) method. We use Multiskan Mk3type microplate reader produced by Shanghai Thermo Fisher Scientific Insrument Co, Ltd and SAA kit produced by the United States R&D company to detect serum SAA levels by enzyme-linked immunosorbent assay(ELISA) method. All operations are strictly operated according to the kit instructions.2. Statistical analysisThe SPSS17.0statistical software package was used for statistical analysis.The measurement data were expressed by mean±standard deviation(x±s),the groups were compared by one-way ANOVA analysis, P value<0.05was considered significant.Results1In the group of50patients with RA in active stage,12subjects were male,38subjects were female,the mean age was (46.54±13.16) years old. In the group of50patients with RA in inactive stage,10subjects were male,40subjects were female, the mean age was (41.82±14.34) years old. In the group of30normal controls,10subjects were male,20subjects were female, the mean age was (43.03±13.35) years old. There were no statistical differences among the three groups in age and gender (P>0.05).2The serum levels of C1q,SAA and IL-6in the group of patients with RA in active stage were (27.32±8.31) mg/dl、(2953.91±874.17) μg/ml、(78.06±36.22) pg/ml, the serum levels of C1q,SAA and IL-6in the group of patients with RA in inactive stage were (22.41±4.91) mg/dl、(211.91±52.56)μg/dl、(5.47±1.65) pg/ml, the serum levels of C1q,SAA and IL-6in the group of normal controls were (16.62±4.86) mg/dl、(185.08±61.38)μg/ml、(2.38±0.47) pg/ml. The serum Clq levels in the group of patients with RA in active stage was higher than that in the group of patients with RA in inactive stage and the normal control group, the serum Clq levels in the group of patients with RA in inactive stage was higher than that in the normal control group, and it has the statistical Signifcance (P<0.05), the serum SAA and IL-6levels in the group of patients with RA in active stage were higher than those in the group of patients with RA in inactive stage and the normal control group, and it has the statistical Signifcance (P<0.05), there were no statistical differences between the group of patients with RA in inactive stage and the normal control group in the serum SAA and IL-6levels(P>0.05).Conclusions1The serum levels of Clq, SAA and IL-6are highly expressed in the serum of patients with RA in active stage. The changes of serum C1q、SAA and IL-6levels in patients with RA have relations with the disease activity of RA, and they may become the clinical indicators of condition monitoring and curative effect assessment of patients with RA.2Clq, SAA and IL-6play an important role in the occurrence and development process of RA.Discussing the role of the three in the pathogenesis of RA may be beneficial for observing the therapeutic effect of RA,so as to better guide the clinical treatment opf RA... |
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