痛风患者外周血中炎症因子IL-18、IL-1β、TNF-α的变化  

Changes of inflammatory cytokines IL-18,IL-1 beta and TNF alpha in peripheral blood of patients with gout

作　　者：黄继勇[1] 张艳[2] HUANG Ji-yong ZHANG Yan(Department of Immunology and Rheumatology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310005, China)

机构地区：[1]浙江中医药大学附属第二医院风湿免疫科,浙江杭州310005 [2]浙江中医药大学附属第三医院ICU,浙江杭州310005

出　　处：《中华全科医学》2017年第9期1487-1489,共3页Chinese Journal of General Practice

基　　金：浙江省自然基金(LY15H270005);浙江省中医药科技计划(2014ZA057);浙江省中医药科技计划(2012-ZA061)

摘　　要：目的了解痛风患者外周血中炎症因子IL-18、IL-1β、TNF-α的变化,探讨其在痛风发病中的作用。方法病例选自2013年8月—2014年10月浙江中医药大学附属第二医院门诊及病房就诊患者,痛风组共49例(急性期24例、间歇期25例),正常对照组为同期门诊健康体检人群,共16例。均抽空腹外周静脉血,检测血尿酸、C反应蛋白(CRP)、白细胞介素-1β(interleukin-1 beta,IL-1β)、白细胞介素-18(interleukin-18,IL-18)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)。结果痛风组与正常对照组血清IL-18分别是[105.66(43.32,190.83)]pg/ml、[0.00(0.00,0.00)]pg/ml,IL-1β分别是[0.00(0.00,0.15)]pg/ml、[0.03(0.00,0.30)]pg/ml,TNF-α分别是[0.00(0.00,4.60)]pg/ml、[0.00(0.00,6.77)]pg/ml,2组相比IL-18差异有统计学意义(P<0.001),IL-1β与TNF-α差异无统计学意义(P>0.05)。痛风患者血尿酸与炎症因子关联性分析结果表明:尿酸与IL-18呈正相关(rs=0.497,P<0.001);CRP与IL-18呈正相关(rs=0.366,P=0.010);血清中IL-18、IL-1β、TNF-α的变化无相关性(P>0.05)。急性期尿酸与TNF-α呈负相关(r=-0.431,P=0.036);间歇期,IL-18与IL-1β呈负相关(rs=-0.402,P=0.046),尿酸与炎症因子不相关,尿酸与CRP不相关。结论痛风患者外周血中IL-18显著增高,IL-18可能参与痛风的慢性炎症过程,并与尿酸的升高相关。Objective To investigate the changes of inflammatory cytokines IL-18,IL-1 beta and TNF alpha in peripheral blood in patients with gout,and explore its role in gout and high uric acid hematic disease. Methods A total 49 cases were recruited from outpatients in our hospital and ward patients between August,2013 and October,2014 （includes 24 cases in acute phase and 25 cases in intermission）. 9 cases in normal control group came from health check-up crowd in the same period in outpatients. The fast peripheral venous blood was prepared, and the levels of blood uric acid, C-reactive protein （ CRP）, interleukin 1 beta （ interleukin 1 beta, IL-1β）, interleukin-18 （ interleukin-18, IL-18 ） and tumor necrosis factor alpha（ Tumor necrosis factor-alpha, TNF-α） were tested. Results The serum level of IL-18 in Gout group and the normal control group were [ 105.66 （43.32,190.83 ） ] pg/ml and [ 0.00 （ 0.00,0.00 ） ] pg/ml, respectively ;levels of IL-1β were [ 0.00 （ 0.00,0.15 ） ] pg/ml and [ 0. 03 （ 0.00,0.30 ） ] pg/ml, levels of TNF-α were [ 0.00 （ 0.00,4.60 ） ] pg/ml and [0.00（0.00,6.77 ） ] pg/ml. When compared with normal control group, the difference in IL-18 was statistically signifi- cant （rs= 0. 497, P 〈 0. 001 ）. CRP and IL-18 were positively correlated（ rs = 0.366, P = 0.010） ;There was no correlation between the changes of IL-18, IL-1 and TNF-α. But Uric acid and TNF-α were negative correlated （ r = - 0. 431, P = 0. 036） in acute stage. In intermission, IL-18 and IL-1 β were negative correlated （ rs = - 0.402, P = 0.046 ）, There was no correlation IL-18, IL-1β,TNF-α, CRP with Uric acid. Conclusion The level of IL-18 in the peripheral blood raise significantly in gout patients. IL-18 may participate in the process of chronic inflammatory in gout and relate to the in- crease of uric acid.

关 键 词：痛风 尿酸 白细胞介素-18 白细胞介素-1Β 肿瘤坏死因子-α 

分 类 号：R753.9[医药卫生—皮肤病学与性病学]