本文選題：CRP　切入點：骨性關節(jié)炎　出處：《新鄉(xiāng)醫(yī)學院》2015年碩士論文

【摘要】：背景非化膿性關節(jié)炎(Non-suppurative arthritis)是一種常見的以關節(jié)組織慢性炎癥性變?yōu)橹饕憩F(xiàn)的全身性疾病,本病侵犯多個關節(jié)。非化膿性關節(jié)炎包括血友病性關節(jié)炎、痛風性關節(jié)炎、大骨節(jié)病、類風濕性關節(jié)炎、強直性脊柱炎及骨性關節(jié)炎等。而骨性關節(jié)炎(osteoarthritis,OA)和類風濕性關節(jié)炎(Rheumatoid arthritis,RA)在臨床上較為多見。我國作為一個人口大國,伴隨著老齡化社會的到來,60歲以上人口更是超過了1億,而未來將會出現(xiàn)越來越多的OA、RA患者。目的研究非化膿性關節(jié)炎患者(以OA、RA患者為主要研究對象)血清及膝關節(jié)滑膜中IL-1、IL-6和TNF-α等炎癥因子指標與C反應蛋白(C reactive protein,CRP)輕度增高(CRP介于10-30mg/L之間)之間的相關性。方法選取2013年1月到2014年1月在新鄉(xiāng)醫(yī)學院第一附屬醫(yī)院入院,并通過全面的體格檢查和影像學檢查確診為骨性關節(jié)炎和類風濕性關節(jié)炎的患者。選取CRP輕度增高的骨性關節(jié)炎和類風濕性關節(jié)炎患者10例(CRP介于10-30mg/L之間)為實驗組。另選取CRP處于正常值(CRP≤10mg/L)的骨性關節(jié)炎和類風濕性關節(jié)炎患者10例,為對照組。采用ELISA法檢測兩組患者血清中IL-1、IL-6及TNF-α的水平。采用免疫組化等方法檢測兩組患者關節(jié)滑膜中IL-1、IL-6及TNF-α的水平。應用HE石蠟染色法鏡下分析兩組患者膝關節(jié)滑膜表達情況,從三種實驗中得出結果,并結合CRP值對實驗組和對照組進行對比及分析。結果1.通過ELISA法檢測,實驗組患者血清中IL-1、IL-6及TNF-α的水平表達明顯高于對照組。2.通過免疫組化方法檢測,患者膝關節(jié)滑膜中IL-1、IL-6及TNF-α的水平表達明顯高于對照組。3.HE染色關節(jié)滑膜組織鏡下對比,實驗組鏡下陽性表達高于對照組,與CRP的輕度增高呈正相關性。結論1.OA、RA患者血清及膝關節(jié)滑膜中IL-1、IL-6、TNF-α等炎癥因子水平的增高與術前無感染灶的情況下CRP的輕度增高相關。2.為臨床選擇合適的手術時機,降低關節(jié)置換手術的感染率提供一定的理論依據(jù)。
[Abstract]:Background Non-suppurative arthritis (non-suppurative arthritis) is a common systemic disease characterized by chronic inflammation of the articular tissue, which invades multiple joints. Non-suppurative arthritis includes hemophilia arthritis and gouty arthritis. Kaschin-Beck disease, rheumatoid arthritis, ankylosing spondylitis and osteoarthritis. With the advent of an aging society, more than 100 million people are over 60 years old. In the future, there will be more and more patients with OAA. Objective to study the relationship between serum and synovial cytokines such as IL-1-, IL-6, TNF- 偽 and C-reactive protein C reactive protein (CRP) in patients with non-suppurative arthritis (OA-RA). Methods from January 2013 to January 2014, they were admitted to the first affiliated Hospital of Xinxiang Medical College. The patients with osteoarthritis and rheumatoid arthritis were diagnosed by comprehensive physical examination and imaging examination. Ten patients with mild increase of CRP were selected to be between 10-30mg/L and Osteoarthritis and Rheumatoid Arthritis (RA). In addition, 10 patients with osteoarthritis and rheumatoid arthritis (CRP 鈮，

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