摘要
目的:研究类风湿关节炎(RA)痰瘀证候积分、血管内皮生长因子(VEGF)、血管内皮生长因子受体-2(VEGFR-2)等临床指标相关性。方法:选取符合纳入标准的RA患者58例为RA组,29例健康体检者为正常组,运用ELISA法检测血清VEGF及VEGFR-2表达量。观察2组抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)、红细胞沉降率(ESR)、C-反应蛋白(CRP)、关节肿胀数、关节压痛数,并计算DAS28评分。探讨活动期RA患者痰瘀积分与血清VEGF、VEGFR-2、抗CCP抗体、CRP、ESR、DAS28评分等临床指标的相关性。结果:RA患者痰瘀积分与VEGF、VEGFR-2、CRP、ESR、关节压痛数呈正相关,相关系数r分别为0.026,0.310,0.416,0.308,0.259(P<0.05)。RA组患者VEGF与VEGFR-2、CRP、ESR、DAS28评分、关节压痛数呈正相关,相关系数r分别为0.301,0.414,0.420,0.284,0.400(P<0.05)。结论:痰瘀证候与VEGF、VEGFR-2介导的微血管增生可能存在密切联系。
Objective:To study the correlation between the phlegm and blood stasis integral and the expressions of VEGF and VEGFR-2 in rheumatoid arthritis(RA).Methods:Fifty eight patients who met the inclusion criteria of RA were selected as members of the RA group and 29 healthy subjects as members of the normal group.The expressions of VEGF and VEGFR-2 were detected by ELISA.The anti CCP antibody,rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),joint swelling number and tenderness number of both groups were observed,and the DAS28 score was calculated in order to investigate the correlation between phlegm and blood stasis integral in patients with active RA and VEGF,VEGFR-2,anti CCP antibody,CRP,ESR,DAS28 score and other related clinical indicators.Results:The phlegm and blood stasis integral in RA patients was positively correlated with VEGF,VEGFR-2,CRP,ESR and tenderness number,and the correlation coefficient r was respectively 0.026,0.310,0.416,0.308 and 0.259(P < 0.05).VEGF in group RA was positively correlated with VEGFR-2,CRP,ESR,DAS28 score and tenderness number,and the correlation coefficient r was 0.301,0.414,0.420,0.284 and 0.400 respectively(P < 0.05).Conclusion:Phlegm and stasis syndrome may be closely related to VEGF,VEGFR-2 mediated microvascular proliferation.
引文
[1]秦祖杰.类风湿关节炎的中西医诊治研究进展[J].华夏医学,2011,24(2):224-227.
[2]CHARLES J,MALEMUD.Growth hormone,VEGF andFGF:Involvement in rheumatoid arthritis[J].ClinChim Acta,2007,375(1-2):9-10.
[3]SHIBUYA M.Vascular endothelial growth actor-dependent and independent regulation of angiogenesis[J].BMB Rep,2008,41(4):278-286.
[4]KENDREW J,EBERLEIN C,HEDBERG B,et al.Anantibody targeted to VEGFR-2 Ig domains 4-7 inhibitsVEGFR-2 activation and VEGFR-2-dependent angiogenesis without affecting ligand binding[J].MolCancer Ther,2011,10(5):770-783.
[5]MAEDA K,CHUNG YS,OGAWA Y,et al.Prognosticvalue of vascular endothelial growth factor expressionin gastric carcinoma[J].Cancer,1996,77(5):858-863.
[6]任海霞,肖诚,李梢,等.类风湿关节炎中的血管生成相关因子研究进展[J].中国中医基础医学杂志,2007,13(4):315-318.
[7]江一平.略论痰瘀胶结在尪痹发病与治疗中的意义[J].江西中医药,2004,35(6):13-14.
[8]唐先平,胡荫奇.“痰瘀相关”与类风湿性关节炎[J].中华中医药杂志,2005,20(3):173-176.
[9]朱震,张世勤,汪悦,等.类风湿性关节炎中医证素分布研究[J].南京中医药大学学报,2012,28(6):531-534.