标题：类风湿关节炎患者治疗前尿沉渣中miR146a的表达与治疗效果的关系

      作者：李博，胡秋侠，吴系美，佘若男，谭锦辉，胡建云    (深圳市龙华区人民医院风湿免疫科，广东 深圳 518109)

      卷次： 2018年29卷17期

      【摘要】 目的 探讨类风湿关节炎(RA)患者治疗前尿沉渣中miR146a的表达与益赛普治疗效果的相关性。方法 2013年6月至2016年3月，收集117例来自深圳市龙华区人民医院风湿免疫科的符合入选标准的中国RA患者作为研究对象，对其进行为期3个月的益赛普的治疗。采用美国风湿病学会与欧洲抗风湿病联盟联合制定的RA临床缓解标准，对益赛普治疗RA的疗效进行评估。采用实时荧光定量逆转录聚合酶链反应方法，在治疗前对研究对象尿沉渣中miR146a的表达水平进行检测。在治疗结束后，统计分析治疗前尿沉渣中miR146a的表达水平与益赛普治疗 RA效果的相关性。结果 治疗结束时，达到 RA临床缓解标准的 RA患者 91例(77.8%)，其余 26例(22.2%)RA患者未达到临床缓解新标准。达到RA临床缓解标准的RA患者的尿沉渣中miR146a的表达水平为(0.39±0.26)，而未达到RA临床缓解标准的患者的表达水平为(0.89±0.31)，前者明显低于后者，差异有统计学意义(P<0.05)。结论 治疗前尿沉渣中miR146a的表达水平与益赛普治疗RA的疗效可能相关，具有较低的miR146a表达水平的RA患者对益赛普的疗效反应较好，有可能作为益赛普对RA的疗效预测指标，其具体机制尚需进一步的研究。
      【关键词】 miR146a；益赛普；类风湿关节炎；疗效
      【中图分类号】 R593.22 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2490—03

Correlations between expression of urinary miR146a and efficacy of rTNF-alpha for rheumatoid arthritis.
LI Bo,HU Qiu-xia, WU Xi-mei, SHE Ruo-nan, TAN Jin-hui, HU Jian-yun. The People's Hospital of Longhua District ofShenzhen, Shenzhen 518109, Guangdong, CHINA
【Abstract】 Objective To explore the correlations between the expression of urinary miR146a in patients withrheumatoid arthritis (RA) and the efficacy of recombinant human tumor necrosis factor-alpha (rTNF-alpha) for RA.Methods A total of 117 patients with RA meeting the inclusion criteria, who admitted to Department of Rheumatologyin the People's Hospital of Longhua District of Shenzhen from June 2013 to March 2016, were collected as research ob-jects. The patients received therapy of rTNF-alpha plus methotrexate (MTX) for 3 months. The rheumatoid arthritis clas-sification criteria formulated jointly by the American College of Rheumatology (ACR) and the European League AgainstRheumatism was used to evaluate the efficacy of rTNF-alpha in the treatment of RA. Quantitative real-time RT-Poly-merase chain reaction (RT-PCR) was performed to determine the expression levels of urinary miR146a in RA patients.The association of the expression of urinary miR146a with the efficacy of RTNF-alpha in the treatment of RA was ana-lyzed after the treatment. Results At the end of treatment, 91 RA patients achieved RA clinical remission criteria(77.8%), and the remaining 26 (22.2%) RA patients did not meet the new clinical remission criteria. The expression levelof urinary miR146a in RA patients who achieved remission was (0.39±0.26) versus (0.89±0.31) in those who did notachieved remission (P<0.05). Conclusion The results indicate that urinary miR146a might be used to predict the effica-cy of rTNF-alpha for RA.
      【Key words】 miR-146a; Recombinant human tumor necrosis factor-alpha (rTNF-alpha); Rheumatoid arthritis;Efficacy·临床经验·doi:10.3969/j.issn.1003-6350.2018.17.035基金项目：广东省医学科研基金立项课题(编号：A2013611)；广东省深圳市卫生计生系统科研项目(编号：201501051、201601060)；广东省深圳市华区科技创新资金项目(编号：20170919A1030357)