CAJ | 학술논문

目的：通过检测类风湿关节炎(RA)患者血浆中miR-146a的表达，探讨miR-146a与疾病活动度的相关性。方法 RA患者40例，其中活动期20例，非活动期20例，留取血浆提取和纯化miRNA，实时定量聚合酶链反应(PCR)检测miR-146a的表达，采用SPSS13.0软件进行统计学分析。结果活动期患者血液中炎性指标类风湿因子（RF)、C反应蛋白(CRP)、血沉（ESR)明显增高；受累指关节滑膜增生厚度、miR-146a的表达明显高于非活动期患者，差异有统计学意义(P<0.05)；而两组患者的抗CCP抗体、受累指关节滑膜血流分级与滑膜动脉阻力指数(RI)比较差异均无统计学意义(P>0.05)。在RA活动期患者体内，miR-146a与滑膜增生厚度、血流分级、RF均有明显的正相关(P<0.05)；而与血液中其他一些炎症指标(ESR、CRP、抗CCP)均无相关性(P>0.05)。而非活动期患者的miR-146a与各项炎症指数均无关联(P>0.05)。结论 miR-146a在RA活动期患者血浆中高表达，且与反映RA患者病情活动度的一些特异性指标相关，而与其他一些非特异性指标无相关，提示血浆miR-146a可以作为RA患者疾病活动度的一个较特异性的预测指标。
목적：통과검측류풍습관절염(RA)환자혈장중miR-146a적표체，탐토miR-146a여질병활동도적상관성。방법 RA환자40례，기중활동기20례，비활동기20례，류취혈장제취화순화miRNA，실시정량취합매련반응(PCR)검측miR-146a적표체，채용SPSS13.0연건진행통계학분석。결과활동기환자혈액중염성지표류풍습인자（RF)、C반응단백(CRP)、혈침（ESR)명현증고；수루지관절활막증생후도、miR-146a적표체명현고우비활동기환자，차이유통계학의의(P<0.05)；이량조환자적항CCP항체、수루지관절활막혈류분급여활막동맥조력지수(RI)비교차이균무통계학의의(P>0.05)。재RA활동기환자체내，miR-146a여활막증생후도、혈류분급、RF균유명현적정상관(P<0.05)；이여혈액중기타일사염증지표(ESR、CRP、항CCP)균무상관성(P>0.05)。이비활동기환자적miR-146a여각항염증지수균무관련(P>0.05)。결론 miR-146a재RA활동기환자혈장중고표체，차여반영RA환자병정활동도적일사특이성지표상관，이여기타일사비특이성지표무상관，제시혈장miR-146a가이작위RA환자질병활동도적일개교특이성적예측지표。
Objective To explore the expression of miR-146a in patients with rheumatoid arthritis (RA), and to analyze the correlation between miR-146a and disease activity degree. Methods Plasma were separated from the peripheral blood of 40 RA patients (20 of active stage and 20 of inactive stage). Total RNAs were isolated and microR-NA (miRNAs) were purified. The levels of miR-146a were determined by quantitative reverse transcription PCR (qRT-PCR). Statistical data were analyzed using SPSS13.0 Software. Results The blood inflammatory markers, includ-ing rheumatoid factor (RF), C reactive protein (CRP), erythrocyte sedimentation rate (ESR) in patients of active stage were increased significantly. The synovial hyperplasia, the miR-146a expression level in patients of active stage were significantly higher than those of inactive stage (P<0.05). There was no significant difference between the two groups in anti-CCP antibody, synovial blood flow grading and synovial artery RI (P>0.05). There was significantly positive corre-lation between miR-146a and synovial hyperplasia thickness, grade of blood flow, RF in active RA patients (P<0.05), but there was no significant correlation between miR-146a and other inflammatory markers (ESR, CRP, anti CCP) in the blood (P>0.05). In inactive patients, miR-146a showed no association with inflammatory indexes (P>0.05). Conclusion miR-146a shows high expression in active RA plasma, and is associated with specific indicators of dis-ease activity degree, which can be used as a predictor of disease activity degree of RA patients.