Effect Of Leflunomide Combined With Hydroxychloroquine On Expression Of IL-17,IL-23 And TGF-beta In Peripheral Blood Of Patients With Rheumatoid Arthritis And Its Clinical Significance

Objective:(1)To investigate the expression and clinical significance of IL-17,IL-23 and TGF-beta in peripheral blood of patients with rheumatoid arthritis.(2)Objective to the changes and significance of leflunomide combined with hydroxychloroquine on the level of immune cell factors in RA patients and further explore the potential value of cytokines in guiding clinical use of drugs.Methods: 50 cases of RA in the first diagnosed active phase were selected as the observation group,including 16 males and 34 females,aged 19 to 66 years,with an average age of 48.0 ±8.4 years.The course of disease was 2-96 months,with an average of 30 months.A total of 50 healthy persons from the out-patient physical examination center in our hospital were selected as control group,including 22 males and 28 females,aged 18 to 62 years old,with an average age of 44.6 ±10.4 years.During the study,all patients were given oral fluomide,The first 3 days 50 mg/ times,then 20 mg/ times,1 times,200mg/ times,2 times with hydroxychloroquine sulfate,before and twelfth weeks after treatment,and used enzyme linked immunosorbent assay(Enzyme linked immuno sorbent assay,ELISA)to detect cell factor interleukins-17(IL-17),white medium The expression level of-23(IL-23)and transforming factor beta(TGF-beta),and the data of ESR,CRP,RF,and the number of swelling joints and the number of pressure joint were collected.Objective to analyze the characteristics of immune cytokines in patients with RA,and to evaluate the effects of leflunomide and hydroxychloroquine on the test index and clinical efficacy.Results:(1)There was no significant difference in gender and age between RA group and healthy control group(P>0.05).There was no significant difference in gender and age between two groups.(2)The levels of IL-17,IL-23 and TGF-beta in peripheral blood of RA patients were significantly higher than those in the healthy control group.The difference was statistically significant(P<0.05).After 12 weeks of treatment,the expression level of IL-17,IL-23 and TGF-beta in the peripheral blood of RA was significantly lower than that before the treatment.The difference was statistically significant(P<0.05).(3)The ESR,CRP and RF in peripheral blood of RA patients were significantly higher than those in the healthy control group(P<0.05).After treatment,the level of ESR,CRP and RF in the peripheral blood of RA patients decreased significantly(P<0.05).The number of joint pressure and joint swelling were significantly lower than those before treatment(P<0.05).Conclusion: The expression level of IL-17,IL-23 and TGF-beta in the peripheral blood of RA patients was higher than that of the normal group.After 3 months of leflunomide combined with hydroxychloroquine,the expression level was obviously decreased and the clinical observation index decreased obviously.It suggested that leflunomide combined with hydroxychloroquine could relieve the clinical symptoms of RA and reduce IL-17,IL-23 and TGF-beta cells.The expression level of the factor.