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目的 研究类风湿关节炎 (RA)患者血清白细胞介素 (IL) 6、皮质醇节律及其临床意义。方法 36例RA患者分别于 8:0 0、12 :0 0、16 :0 0、2 0 :0 0、0 :0 0、4 :0 0用双抗体夹心酶联免疫吸附试验 (ELISA)检测其血清IL 6水平 ,用放射免疫法 (RIA)测定皮质醇。结果 36例RA患者皮质醇分泌有明显节律 ,但与正常对照组相比 ,其峰值提前 ,出现于凌晨 4点。血清IL 6水平高于对照组 (P <0 0 1) ,也存在昼夜节律。IL 6峰值出现在皮质醇峰值之前。经治疗病情稳定后 ,RA患者血清IL 6水平恢复或接近正常 ,IL 6与皮质醇节律紊乱得以纠正。相关性分析显示 ,RA患者血清IL 6水平与血沉 (ESR) (P <0 0 1,r=0 6 6 )、C反应蛋白 (CRP) (P <0 0 1,r =0 71)、皮质醇 (P <0 0 5 ,r=0 5 8)呈正相关。结论 RA患者血清IL 6增高 ,IL 6与皮质醇存在昼夜节律紊乱 ,这些变化在RA的发病机制中可能具有重要意义
Objective To study the serum interleukin (IL) 6 and cortisol rhythm in patients with rheumatoid arthritis (RA) and its clinical significance. Methods Thirty-six patients with RA were examined by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) at 8:01, 0:06, 0:01, 0:01, 0:01, The level of serum IL 6, radioimmunoassay (RIA) determination of cortisol. Results There were obvious rhythms of cortisol secretion in 36 patients with RA, but the peak value appeared earlier than that of the normal control group and appeared at 4:00. The level of serum IL-6 was higher than that of the control group (P <0.01), and circadian rhythm also existed. IL 6 peak appeared before cortisol peak. After the treatment of stable disease, RA patients with serum IL 6 levels recovered or nearly normal, IL 6 and cortisol rhythm disorders can be corrected. Correlation analysis showed that serum IL-6 levels in patients with RA were significantly correlated with ESR (P <0.01 or r = 0.676), C-reactive protein (CRP) Alcohol (P <0 05, r = 0 58) showed a positive correlation. Conclusion Serum IL 6 is increased in patients with RA, and circadian rhythm disorder exists between IL 6 and cortisol. These changes may play an important role in the pathogenesis of RA