Takei S, Imanaka H, Maeno N, Shigemori M, Masuda K, Hokonohara M, Miyata K
Department of Pediatrics, Faculty of Medicine, Kagoshima University, Japan.
J Rheumatol. 1996 Nov;23(11):1956-62.
Elevated serum levels of hyaluronic acid (HA) correlate with joint inflammation in adult rheumatoid arthritis (RA). There are no laboratory indices for specifically assessing joint inflammation. Therefore, serial measurements of HA were assessed as a possible tool for measuring the severity of arthritic symptoms in children with juvenile rheumatoid arthritis (JRA).
Serum levels of HA, measured by a sandwich assay method using HA binding protein, were correlated with the severity of joint symptoms and with laboratory test values in 71 patients with JRA, 30 children with other rheumatic diseases, and 138 children without rheumatic disease.
Serum levels of HA showed significant correlation with the severity of joint symptoms, but not with systemic symptoms, in patients with systemic and polyarticular JRA. No other laboratory tests, including C-reactive protein and erythrocyte sedimentation rate, reflected the severity of joint symptoms. This correlation of serum levels of HA with joint symptoms was observed in patients with systemic and polyarticular JRA, but not in pauciarticular JRA, other rheumatic diseases, or nonrheumatic diseases, even when signs of arthritis were present in the latter 3 groups.
Serum levels of HA are useful in objectively evaluating arthritic symptoms in patients with systemic and polyarticular JRA, and may have diagnostic value in this disease.
血清透明质酸（HA）水平升高与成人类风湿关节炎（RA）的关节炎症相关。目前尚无专门用于评估关节炎症的实验室指标。因此，对HA进行连续测量被评估为一种测量幼年类风湿关节炎（JRA）患儿关节炎症状严重程度的可能工具。
采用HA结合蛋白夹心测定法测量71例JRA患儿、30例患有其他风湿性疾病的儿童以及138例无风湿性疾病的儿童的血清HA水平，并将其与关节症状严重程度及实验室检查值进行关联分析。
在全身型和多关节型JRA患者中，血清HA水平与关节症状严重程度显著相关，但与全身症状无关。包括C反应蛋白和红细胞沉降率在内的其他实验室检查均未反映关节症状的严重程度。血清HA水平与关节症状的这种相关性在全身型和多关节型JRA患者中观察到，但在少关节型JRA、其他风湿性疾病或非风湿性疾病患者中未观察到，即使后三组存在关节炎体征。
血清HA水平有助于客观评估全身型和多关节型JRA患者的关节炎症状，并且可能对该疾病具有诊断价值。
