血清及关节液中单核因子表达水平的测定及其在幼年脊柱关节病中的临床意义  

Comparative study of serum and synovial fluid monokine levels in patients with juvenile spondyloarthropathies and their clinical significance

作　　者：赵伟[1] 黄烽[1] 徐明[1] 丁玉珍[1] 

机构地区：[1]解放军总医院风湿科,北京100853

出　　处：《中华风湿病学杂志》2001年第6期346-349,共4页Chinese Journal of Rheumatology

基　　金：国家自然科学基金资助项目 (A39870 72 0 )

摘　　要：目的　研究单核因子在幼年脊柱关节病 (JSpA)发病机制中的作用及其与疾病活动性的相互关系。方法　用夹心ELISA法同时测定JSpA患者血清、关节液及健康志愿者血清中白细胞介素 1α (IL 1α)、IL 1β、IL 6、IL 8、IL 12、肿瘤坏死因子 α (TNF α)等单核因子水平及部分炎性指标水平 ,同时对血清中各单核因子与炎性指标的相关性、各单核因子在血清和关节液中水平的相关性进行分析。结果　JSpA患者血清IL 6水平高于健康对照组 (P <0 0 1) ,而IL 1β水平却明显低于健康对照组 (P <0 0 0 1) ,除IL 12外 ,关节液中其他单核因子水平均明显高于血清水平 (P <0 0 1)。血清中部分单核因子水平与炎性指标 (红细胞沉降率、C反应蛋白、血小板计数等 )呈一定程度的正相关 ,其中IL 6水平与炎症指标的相关性最为密切 (相关系数r分别为 0 6 2 6、0 5 11、0 5 0 4,P值分别为 0 0 0 95、0 0 42 9、0 0 46 3)。血清中TNF α和IL 1α水平明显正相关 (r =0 94,P <0 0 1) ,IL 12和IL 1β水平正相关 (r =0 6 0 ,P <0 0 5 )。TNF α在JSpA患者血清和关节液中表达水平呈明显正相关 (r =0 86 ,P <0 0 0 0 1) ,血清中IL 1β与关节液中的TNF α水平呈明显负相关 (r =- 0 86 ,P <0 0 0 0 1)。关节液中IL 12和IL 8水?Objective To determine the monokine levels of serum and synovial fluid (SF) in patients with JSpAs and estimate the correlation between monokines and inflammatory indices.Methods Serum and SF monokines (IL 1α,IL 1β,IL 6,IL 8,IL 12 and TNF α) were measured by sandwich ELISA in patients with JSpAs ( n =28) and healthy controls ( n =10).The correlation between serum monokines and inflammatory indeces and between both serum and SF monokine levels was analysed.Results Elevated serum level of IL 6 was found in patients with JSpAs as compared to healthy controls ( P <0 01),but the IL 1β level in serum of patients with JSpAs was significantly lower than that of healthy controls ( P <0 001).All monokine (except IL 12) levels were significantly higher in SF than in serum ( P <0 01).Elevated levels of monokine in serum were correlated with some inflammatory indices,and the IL 6 level was most significantly correlated with the inflammatory indices (including ESR,CRP platelet count).The correlation coefficients r between serum IL 6 level and inflammatorrindices were 0 626,0 511 and 0 504 and the corresponding P values 0 009 5,0 042 9 and 0 046 3 respectively.Correlations were found between TNF α and IL 1α ( r =0 84, P <0 01),IL 12 and IL 1β ( r =0 60, P <0 05) in serum.Correlations also existed between serum and SF levels of TNF α ( r =0 86, P =0 000 1),IL 1β level in serum and IL 6 level in SF ( r =-0 86, P =0 000 1).Correlation was also found between IL 12 and IL 8 ( r =0 66, P <0 01) in SF.Conclusion These results point to a pathogenic role of the monokine network in JSpAs and these data may suggest an important role of cellular immune activation in the pathogenesis.

关 键 词：单核细胞激活性 病理学 幼年型脊柱关节病 JSpA 

分 类 号：R593.2[医药卫生—内科学]