基于细胞因子/NF-κB信号通路探讨强直性脊柱炎患者血瘀状态形成的机制  

Mechanism of Ankylosing Spondylitis Patients with Blood Stasis Based on Cytokines NF-κB Signaling Pathway

作　　者：方利[1] 刘健[2] 朱福兵 章平衡 谈冰[1] 

机构地区：[1]安徽中医药大学,安徽合肥230038 [2]安徽省中医院风湿科,安徽合肥230031

出　　处：《中华中医药学刊》2016年第12期2913-2917,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家科技支撑计划项目(2012BA126B02);国家中医药管理局重点学科中医痹病学项目(国中医药发[2009]30号);国家临床重点专科中医风湿病建设项目(财社[2013]239号);安徽省重点实验室建设项目(1306c083035);安徽省科技计划项目(11010402170)

摘　　要：目的:观察强直性脊柱炎(AS)患者细胞因子/核因子(NF)-κB信号传导通路相关指标的变化,探讨强直性脊柱炎患者血瘀状态形成的机制。方法:采用酶联免疫吸附法(ELISA)检测30例AS患者和30例健康对照外周血血清中肿瘤坏死因子(TNF)-α、白介素(IL)-1β、IL-10、IL-17、核因子激活剂(Act1)、NF-κB抑制蛋白(IκBα)、Ik B激酶(IKKβ)、核转录因子(NF-κB)/P65、NF-κB/P50、血栓素A2(TXA2)、前列环素I2(PGI2)、P-选择素(GMP140或CD62p)、血小板活化因子(PAF)的含量,观察AS患者实验室指标及血瘀症状体征。结果:(1)AS患者外周血血清中的TNF-α、IL-1β、IL-17、Act1、NF-κB/P65、NF-κB/P50、IκBα、IKKβ、GMP140、PAF、TXA2的含量明显高于健康对照组(P<0.05或P<0.01);IL-10、PGI2含量明显低于健康对照组(P<0.05或P<0.01)。AS患者实验室指标血小板(PLT)、纤维蛋白原(FBG)、D-二聚体(D-D)、红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)明显高于健康对照组(P<0.05或P<0.01)。(2)相关性分析显示,AS患者关节刺痛、唇色、舌质、脉象、皮下瘀斑、肌肤甲错、善忘及血瘀症状总积分与PLT、FBG、D-D呈正相关(P<0.05或P<0.01);AS患者TNF-α、IL-1β、IL-17、Act1、IKKβ、IκBα、NF-κB/P65、NF-κB/P50、GMP140、PAF、TXA2、ESR、hs-CRP、VAS、BASDAI与PLT、FBG、D-D、血瘀症状总积分呈正相关(P<0.05或P<0.01);IL-10、PGI2与PLT、FBG、D-D、血瘀症状总积分呈负相关(P<0.05或P<0.01)。结论:AS患者体内存在血瘀状态形成,且与细胞因子紊乱及NF-κB激活有关。细胞因子紊乱/NF-κB信号通路过度活化可能是AS血瘀状态形成的机制。Objective： To observe the cytokines and related indicators of nuclear factor（NF）-κB signal pathway and to explore the mechanism of the blood stasis state in patients with ankylosing spondylitis（AS）.Methods： In total,30 patients with ankylosing spondylitis（AS） and 30 healthy controls were enrolled in this study.Enzyme-linked immunosorbent method（ELISA） was used to detect peripheral blood serum related indicators such as tumor necrosis factor-alpha（TNF-α）,interleukin（IL）-1β,IL-10,IL-17,nuclear factor activation agent（Act1）,NF-κB inhibition protein（IκB-α）,IκB kinase（IKKβ）,a nuclear transcription factor（NF-κB）/P65,NF-κB/P50,thromboxane A2（TXA2）,Prostaglandin I2（PGI2）,P-selectin hormone（GMP140 or CD62p） and platelet activating factor（PAF）.The laboratory parameters and clinical symptoms in AS patients were observed.Results：（1） Compared with healthy control group,TNF-α,IL-1β,IL-17,Act1,NF-κB/p65,NF-κB/P50,IκBα,IKKβ,TXA2,GMP-140 and PAF in patients with AS were significantly higher,but IL-10 and PGI2 were significantly decreased（P〈0.05 or P〈0.01）.The laboratory indexes such as platelet（PLT）,protein fiber（FBG）,D-Dimer（D-D）,red blood cell sedimentation rate（ESR） and high sensitive C-reactive protein（hs-CRP） were significantly higher（P〈0.05 or P〈0.01）.The abnormal rates of D-D,FBG and PLT in AS group were respectively 83.3%,66.7% and 73.3%.（2） Correlation analysis showed that joint tingling,lips,tongue,pulse,ecchymosis,skin armour fault,forget and the total score of blood stasissymptoms in AS patients were positively related to PLT,FBG and D-D（P〈0.05 or P〈0.01）.Moreover,TNF-α,IL-1β,IL-17,Act1,NF-κB/p65,NF-κB/P50,IκBα,IKKβ,GMP-140,PAF,ESR,hs-CRP,VAS,TXA2 and BASDAI were positively related to PLT,FBG,D-D and the total score of blood stasis symptoms（P〈0.05 or P〈0.01）,while IL-10 and PGI2 were negative（P〈0.05 or P〈0.01）.Conclusion： The patients with AS was in blood stasis st

关 键 词：脊柱炎 强直性 NF-ΚB 细胞因子 血瘀状态 

分 类 号：R593.23[医药卫生—内科学]