本文關鍵詞： 類風濕關節(jié) IL-27 RANKL 骨密度 骨質(zhì)疏松　出處：《山西醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的:旨在通過測定RA患者血清中IL-27及RANKL的水平變化,并分析兩者與疾病活動性指標的關系,并初步研究兩者對RA患者骨質(zhì)疏松的影響。方法:選擇入住山西醫(yī)科大學第一醫(yī)院風濕免疫科,并明確診斷為RA的患者55例為試驗組,均符合2010年ACR/EULAR的RA分類標準,同時符合相應入選及排除標準。并選擇同時期于我院體檢的年齡和性別相匹配的正常體檢者42例作為對照組。清晨收集兩組入選者空腹靜脈血,盡快分離并保存血清。采用ELISA法測定兩組血清中IL-27及RANKL水平,采用跟骨超聲骨密度儀測定骨密度(BMD),進一步分析RA患者血清IL-27、RANKL水平的變化及兩者與疾病活動性指標的關系,并探討兩者與骨質(zhì)疏松間的聯(lián)系。結(jié)果:1.與對照組相比較,RA組骨密度明顯降低(P=0.004),且骨質(zhì)疏松發(fā)生率為52.8%,明顯高于對照組19.1%;2.RA組血清IL-27、RANKL及IL-27/RANKL比值,與對照組IL-27、RANKL及IL-27/RANKL比值相比均明顯升高(P均㩳0.05);3.RA組中,IL-27、RANKL、IL-27/RANKL與反應疾病活動度指標(關節(jié)腫脹數(shù)、關節(jié)壓痛數(shù)、血沉、抗CCP抗體、DAS28評分等)均無相關性(P均㧐0.05);4.RA組中IL-27、RANKL、IL-27/RANKL與骨密度均無相關性,且三者在骨質(zhì)疏松、骨量減少、骨量正常三組中亦無明顯差異(P均㧐0.05)。結(jié)論:1.RA患者的骨密度較正常人群是明顯降低的,同時存在較高的骨質(zhì)疏松發(fā)生;2.RA患者血清中IL-27、RANKL水平及IL-27/RANKL比值均明顯升高,但與疾病活動性指標均無相關性,提示兩者并不能反映疾病活動性;3.IL-27可能通過某種機制影響RA的骨代謝,具體機制有待進一步研究。
[Abstract]:Objective: to determine the changes of serum IL-27 and RANKL levels in RA patients, and to analyze the relationship between them and disease activity index. Methods: 55 patients who were admitted to the Department of Rheumatological Immunology in the first Hospital of Shanxi Medical University and 55 patients diagnosed as RA were selected as the experimental group. All of them were in accordance with the ACR/EULAR classification criteria of RA in 2010. At the same time, 42 cases of normal physical examination matched with age and sex in our hospital were selected as control group. Fasting venous blood was collected from two groups in the morning. Serum samples were isolated and preserved as soon as possible. Serum IL-27 and RANKL levels were measured by ELISA method, bone mineral density (BMD) was measured by calcaneal ultrasound absorptiometry. The changes of serum IL-27 RANKL levels and their relationship with disease activity in RA patients were further analyzed. Results compared with the control group, the bone mineral density of RA group was significantly lower than that of the control group, and the incidence of osteoporosis was 52.8, which was significantly higher than that of the control group 19.1and 2.RA, and the ratio of IL-27, RANKL and IL-27/RANKL was significantly higher than that of the control group, and the ratio of IL-27, RANKL and IL-27/RANKL in RA group was significantly higher than that in the control group. Compared with the control group, IL-27 RANKL and IL-27/RANKL ratio were significantly higher than that of the control group. In RA group, there was no correlation between IL-27, RANKL, IL-27 / RANKL and the index of disease activity (joint swelling, joint tenderness, erythrocyte sedimentation rate, anti CCP antibody DAS28 score, etc.). 4. In RA group, IL-27 RANKL / RANKL had no correlation with BMD, and there was no significant difference among the three groups in osteoporosis, decrease of bone mass and normal bone mass. Conclusion the bone mineral density of patients with RA is significantly lower than that of normal controls. There is also a higher incidence of osteoporosis. 2. The level of IL-27 RANKL and the ratio of IL-27/RANKL in patients with RA are significantly increased, but there is no correlation with the activity of the disease. These results suggest that IL-27 may not affect the bone metabolism of RA through some mechanism, and the specific mechanism needs further study.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R593.22

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本文編號：1505774