【摘要】 目的 研究活動期RA患者血清中細胞因子IL-18的表達，并探討它們與疾病活動程度的關系。 方法 2008年12月-2010年1月將63例RA患者，根據DAS28將患者分為高度活動組和低度活動組，應用酶聯免疫吸附法（ELISA）法檢測63例RA患者和27例對照組的白細胞介素-18（IL-18）表達水平。分析IL-18的水平與臨床指標的相關性。 結果 IL-18在活動期RA中表達水平高于低度活動組、對照組，分別為（238.88±41.75）、（189.11±40.62）、（185.42±44.93） pg/mL，有統計學意義（Plt;0.01）。RA活動組患者IL-18與外周血白細胞計數呈負相關（r=-0.628，Plt;0.05）。 結論 IL-18水平在RA活動期患者高表達，在RA發病和發展中起重要作用。【Abstract】 Objective To observe the expression of interleukin-18 (IL-18) in patients with active rheumatoid arthritis (RA). Methods A total of 63 patients with RA in our hospital from December 2008 to January 2010 were selected. The patients were divided into high activity group and low activity group according to the disease activity score 28 (DAS28). Levels of IL-18 in the serum in 63 patients and 27 control individuals were detected by ELISA technique. The relationship between IL-18 expression and the clinical indexes was analyzed. Results IL-18 serum levels were (238.88±41.75), (189.11±40.62), and (185.42±44.93) pg/mL In high activity group, low activity group and the control group respectively with a significant difference (Plt;0.01). The IL-18 level in high activity group was negative correlated with WBC counts. Conclusion Apparent expression of IL-18 is found in RA patients at the active phase, which plays an important role in the occurrence and development of RA.
To make a rabbit model of Perthes disease and to explore the change and its significance of VEGF expression in the femoral head. Methods Twenty-four 3-month-old New Zealand rabbits (weighing 1.6-1.8 kg) were randomly divided into experimental group (n=16) and control group (n=8). A rabbit model of Perthes disease was made by excision of left l igamentum teres and retinacular blood suppl ies of femoral head. The gross appearance, X-ray film and histological observations were made and the immunohistochemistry and VEGF mRNA in situ hybridization were carried out1, 2, 4, 8 weeks after operation. Results The rabbit model of Perthes disease was made successfully; only 1 was infected5 days after operation and was made quit. The gross appearance: The femoral heads had no necrosis changes in control group at every time. The femoral heads became coarse, tarnish and smaller, and even collapsed in experimental group. The HE staining observation: The femoral heads had no necrosis changes in control group at every time after operations. New vessels and granulation tissues grew into the necrosis part in the experimental group 4 weeks and 8 weeks after operations. New bone could be seen in repaired bone. Immunohistochemistry staining: In the epiphyseal cartilage of the femoral heads in control group, an intensive VEGF immunoreactivity (VEGF-IR) was found in the hypertrophic zone with a low level of VEGF-IR in the prol iferative zone. At 1 week after operation, the percentage of VEGF+ cells in the prol iferative zone of the femoral heads in experimental group was increased compared with that of the femoral heads in control group. The percentage of VEGF+ cells in the hypertrophic zone of the femoral heads in experimental group was significantly decreased compared with that of the femoral heads in control group. At 8 weeks after operation, VEGF-IR was observed throughout the epiphyseal cartilage surrounding the bony epiphysis in the femoral heads in experimental group. The percentage of VEGF-positive cells in the prol iferative zone of the femoral heads in experimental group was significantly increased compared with that of the normal heads. The hypertrophiczone of the femoral heads in experimental group had a similar percentage of the VEGF+ cells to the femoral heads in control group when endochondral ossification was restored at 8 weeks. There were statistically significant differences in the ratios of VEGF+ cells in the prol iferative zone of femoral head 1, 2, 4, 8 weeks after operations (P lt; 0.01); in the ratios of VEGF+ cells in the hypotrophic zone of femoral head 1, 2, 4 weeks after operations (P lt; 0.01) between experimental group and control group. In situ hybridization results: The results were similar to that of histology. VEGF mRNA expression in the hypertrophic zone of epiphyseal catilage after necrosis were lower. VEGF mRNA expression in the prol iferative zone of epiphyseal catilage after necrosis increased. VEGF mRNA expression in the hypertrophic zone of epiphyseal cartilage in experimental group could be seen again after endochondral ossification was repaired. Conclusion It is possible that VEGF may act as a key regulator that couples angiogenesis, cartilage remodel ing, and ossification after ischemic damage to restore endochondral ossification in the epiphyseal cartilage.