TNF-α在痛风性关节炎患者炎性反应中的变化及意义  

Changes and significance of TNF-α in inflammatory reaction in patients with gouty arthritis

作　　者：赖爱云[1] 徐健[1] 陶丽[1] LAI Aiyun;XU Jian;TAO Li(Department of Rheumatology and Immunology,The First Affiliated Hospital of Kunming Medical University,Yunnan,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院风湿免疫科,昆明市650032

出　　处：《河北医药》2019年第3期388-391,共4页Hebei Medical Journal

基　　金：云南省医疗卫生科技计划项目(编号:2016NS051)

摘　　要：目的观察痛风性关节炎患者炎性反应中肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、白介素-6(IL-6)、转化生长因子-β(TGF-β)水平的变化,分析与尿酸的相关性。方法回顾性分析2016年1月至2017年12月收治痛风性关节炎患者75例的临床资料,按照痛风性关节炎病情分为急性期痛风性关节炎(AGA) 39例(AGA组),间歇期痛风性关节炎(NAGA) 36例(NAGA组),另选取同期体检的健康人群40例为对照组(CG组);检测各组患者血浆和关节液中TNF-α、IL-1β、IL-6、UA、TGF-β水平,比较各组指标的差异,采用Spearman线性分析各指标的相关性。结果 AGA组、NAGA组血清TNF-α、IL-1β、IL-6、TGF-β、UA水平高于CG组(P <0. 05); AGA组患者TNF-α、IL-1β、IL-6、TGF-β、UA水平高于NAGA组(P <0. 05); AGA组关节液中TNF-α、IL-1β、IL-6、TGF-β、UA水平高于NAGA组(P<0. 05); Spearman相关性分析显示,血清TNF-α水平与IL-1β、IL-6、TGF-β、SUA呈正相关(r=0. 573,0. 862,0. 762,0. 774,P <0. 05); SUA水平与IL-1β、TGF-β、IL-6呈正相关(r=0. 604,0. 805,0. 833,P <0. 05)。结论痛风性关节炎患者机体炎性因子水平明显高于正常人群,血清中TNF-α与尿酸水平呈显著正相关,临床可通过监测炎性因子水平判断疾病严重程度。Objective To observe the changes of levels of TNF-α,IL-1β,IL-6 and TGF-βin patients with gouty arthritis,and to analyze their correlation with uric acid.Methods The clinical data of 75 patients with gouty arthritis who were admitted and treated in our hospital from January 2016 to December 2017 were retrospectively analyzed.According to the condition of gouty arthritis,there were 39 cases of acute gouty arthritis(AGA group),36 cases of intermittent gouty arthritis(NAGA group),and the other 40 healthy subjects who received physical examination in our hospital at the same period were enrolled as control group.The levels of TNF-α,IL-1β,IL-6,UA and TGF-βin plasma and synovial fluid were detected and compared among the three groups.Moreover the correlation among these indexes was analyzed by Spearman linearity.Results The levels of TNF-α,IL-1β,IL-6,TGF-β,UA in AGA group and NAGA group were significantly higher than those in CG group(P<0.05).The levels of IL-6,TGF-βand UA in AGA group were significantly higher than those in NAGA group(P<0.05).The levels of TNF-α,IL-1β,IL-6,TGF-βand UA in articular fluid in AGA group w were significantly higher than those in NAGA group(P<0.05).Spearman correlation analysis showed that the seum levels of TNF-1βwere positively correlated with those of IL-6,TGF-βand SUA(r=0.573,0.862,0.762,0.774,respectively,P<0.05).Moreover the level of SUA were positively correlated with those of IL-1β,TGF-βand IL-6(r=0.604,0.805,0.833,respectively,P<0.05).Conclusion The serum levels of inflammatory cytokines in patients with gouty arthritis are significantly higher than those in healthy subjects.There is a significant positive correlation between serum levels TNF-αand uric acid levels.To monitor the levels of inflammatory cytokines can evaluate the severity of disease.

关 键 词：TNF-Α 痛风性关节炎 炎性反应 相关性 

分 类 号：R593.22[医药卫生—内科学]