發(fā)布時間：2018-04-14 21:50

  本文選題：類風(fēng)濕關(guān)節(jié)炎 + 脂聯(lián)素　； 參考：《吉林大學(xué)》2015年碩士論文

【摘要】：目的：類風(fēng)濕關(guān)節(jié)炎（rheumatoid arthritis，RA）是一種常見的全身性自身免疫病，主要表現(xiàn)為慢性、對稱性的關(guān)節(jié)滑膜炎癥。脂聯(lián)素（adiponectin，APN）有三種亞型，即高分子量（high-molecular weight，HMW）脂聯(lián)素、中分子量（medium-molecular weight，MMW）脂聯(lián)素和低分子量（low-molecular weight，LMW）脂聯(lián)素，這三種APN亞型不僅在數(shù)量上有差異，其生物學(xué)活性也存在很大差異。目前APN在RA發(fā)病中的作用仍有爭議，且國內(nèi)外關(guān)于APN亞型與RA間關(guān)系的研究數(shù)量極少。本文旨在探討總APN以及各亞型APN在RA患者血清中的表達及其與RA的關(guān)系。 方法：納入近期診斷且未經(jīng)治療的RA患者180例（RA組），病程均在1年以內(nèi)，同時選擇160名年齡和性別相匹配的健康體檢者作為對照組，采用酶聯(lián)免疫吸附試驗（enzyme-linked immunosorbent assay，，ELISA）方法測定RA組和健康對照組血清中總APN以及HMW、MMW、LMW型APN水平，同時測定紅細胞沉降率（erythrocyte sedimentation rate，ESR）、C-反應(yīng)蛋白（C-reactive protein，CRP）、抗環(huán)瓜氨酸肽（anti-cyclic citrullinated peptide antibody, CCP）抗體、類風(fēng)濕因子（rheumatoid factor，RF）IgM、RF-IgG、RF-IgA、甘油三酯（triglyceride，TG）、總膽固醇（Total cholesterol，TC）、高密度脂蛋白膽固醇（high density lipoproteincholesterol，HDL-C）、低密度脂蛋白膽固醇（low density lipoprotein cholesterol，LDL-C）、血壓（blood pressure，BP）、血糖（glucose）、身體質(zhì)量指數(shù)（body massindex，BMI)，并計算RA患者28個關(guān)節(jié)的疾病活動度評分（disease activity scorein28joints，DAS28）。 結(jié)果：①與健康對照組相比，RA組患者血清總APN及HMW、MMW、LMW型APN水平顯著降低（P＜0.01）。②RA組血清總APN及HMW、MMW、LMW型脂聯(lián)素水平與血清TG水平呈正相關(guān)，而與DAS28呈負相關(guān)。逐步多元回歸分析顯示血清總APN及HMW、MMW、LMW型APN水平與血清TG水平呈正相關(guān)，血清LMW型APN水平與DAS28呈負相關(guān)。③將RA組患者分為近3個月應(yīng)用NSAIDs(NSAIDs+)及近3個月未應(yīng)用NSANDs (NSAIDs-)兩組，結(jié)果顯示兩組患者血清總APN及HMW、MMW、LMW型APN水平無明顯差異（P＞0.05）。④RF-IgG或RF-IgA或RF-IgM或抗CCP抗體陽性組與RF-IgG或RF-IgA或RF-IgM或抗CCP抗體陰性組RA患者血清總APN及HMW、MMW、LMW型APN水平無明顯差異（P＞0.05）。 結(jié)論：1、RA患者血清中總APN及HMW、MMW及LMW型APN水平均發(fā)生了變化。2、RA患者血清總APN及HMW、MMW、LMW型APN可能影響了血清TG的代謝。3、RA患者血清LMW型APN可能參與了RA疾病活動，血清LMW型APN可以作為評價RA疾病活動性的指標。
[Abstract]:Objective: rheumatoid arthritis (RA) is a common systemic autoimmune disease characterized by chronic, symmetrical synovitis.Adiponectin (APN) has three subtypes: high molecular weight high-molecular weight (HMW) adiponectin, medium molecular weight (MMW) adiponectin and low molecular weight low-weight molecular weight (LMWs) adiponectin. These three APN subtypes not only differ in quantity but also in biological activity.At present, the role of APN in the pathogenesis of RA is still controversial, and there are few studies on the relationship between APN subtypes and RA at home and abroad.The purpose of this study was to investigate the expression of total APN and subtypes of APN in serum of RA patients and their relationship with RA.Methods: 180 newly diagnosed and untreated RA patients were enrolled in this study. The course of disease was less than one year, and 160 healthy persons matched with age and sex were selected as control group.The levels of total APN and HMW-MMWMW-LMW APN in serum of RA group and healthy control group were determined by enzyme-linked immunosorbent assayam-ELISA.The erythrocyte sedimentation rate and erythrocyte sedimentation rate (erythrocyte sedimentation rate) of erythrocyte erythrocyte sedimentation rate- ESRP protein (C-reactive protein), anti-cyclic citrullinated peptide antibody (CCPP) antibody were measured by enzyme-linked immunosorbent assay (Elisa).Rheumatoid factor RF-IgGG, triglyceride triglyceride TGG, total cholesterol total cholesterol cholesterol total cholesterol cholesterol cholesterol high density cholesterol cholesterol cholesterol high density protein cholesterol cholesterol cholesterol low density lipoprotein lipoprotein lipoprotein LDL-C, blood pressure blood pressure blood pressure, blood glucose, body mass index (BMI) body mass index (BMI) BMIA, total cholesterol cholesterol total cholesterol cholesterol (HDL-C), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), low density lipoprotein cholesterol (LDL-C), blood pressure blood pressure (BP), blood glucose glucose, body mass index (BMI), body mass index (BMI), and 28 joint diseases in RA patients were calculated.Disease activity scorein28jointsDAS28.Results compared with the healthy control group, the levels of serum total APN and HMW-MMWMW-LMW type APN in patients with RA were significantly lower than those in the control group (P < P < 0.01).2RA). The levels of serum total APN and HMW-MMWMW-LMW adiponectin were positively correlated with serum TG levels, but negatively correlated with DAS28.Stepwise multivariate regression analysis showed that the serum levels of total APN and APN were positively correlated with the serum TG levels, and the serum LMW APN levels were negatively correlated with DAS28. 3. The patients in RA group were divided into two groups: NSAIDs(NSAIDs in the last 3 months and NSANDs NSAIDs-not in the last 3 months.The results showed that there was no significant difference in serum total APN and APN levels between the two groups (P > P > 0.05). There was no significant difference in serum total APN and HMW-MMWMW-LMW APN levels between RF-IgG or RF-IgA or RF-IgM or anti- antibody negative group and RF-IgG or RF-IgA or RF-IgM or anti- antibody negative group (P > 0.05).Conclusion the levels of total APN, HMWMMW and LMW type APN in serum of patients with RA may be affected by the changes of total APN and MMW type APN in patients with RA, and the level of LMW APN may be involved in the disease activity of RA.Serum LMW type APN can be used as an index to evaluate the disease activity of RA.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R593.22

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