血清白细胞介素-6和白细胞介素-1β水平在预测依那西普治疗类风湿关节炎患者临床应答中的作用  

Predictive Value of Serum Interleukin-1β and Interleukin-6 Levels for Clinical Response to Etanercept Treatment in Patients with Rheumatoid Arthritis

作　　者：姜薇 王娟[2] JIANG Wei;WANG Juan(Department of Rheumatology and Hematology,The Affiliated Hospital of Jianghan University,Wuhan 430015,China;Department of Endocrinology,The Affiliated Hospital of Jianghan University,Wuhan 430015,China)

机构地区：[1]江汉大学附属医院风湿血液内科,武汉430015 [2]江汉大学附属医院内分泌科,武汉430015

出　　处：《中国医科大学学报》2019年第2期175-179,183,共6页Journal of China Medical University

摘　　要：目的通过检测基线期血清8个与炎症调节相关蛋白的表达水平,评估其在预测依那西普(ETN)治疗类风湿关节炎(RA)患者临床应答中的作用。方法研究连续纳入58例接受ETN治疗24周的活动性RA患者。采用酶联免疫吸附实验检测患者基线期血清标志物的表达水平。结果 ETN治疗24周后,38例RA患者达到临床应答,划归为应答组,20例RA患者未达到临床应答,划归为无应答组。应答组患者基线期血清白细胞介素-1β(IL-1β)(P=0.011)和白细胞介素-6 (IL-6)(P=0.004)水平相对于无应答组显著升高。受试者工作特征曲线表明,IL-1β(AUC:0.703,95%CI:0.558～0.847)和IL-6 (AUC:0.732,95%CI:0.601～0.862)表达水平具有较好的区分临床应答和无应答患者的能力。进一步单元、多元回归分析显示,IL-6高表达可以独立预测ETN治疗RA患者更好的临床应答(P=0.031)。结论基线期血清IL-1β和IL-6表达水平可能会作为ETN治疗RA患者临床应答的生物标记物。Objective To investigate the predictive value of eight pro-inflammatory protein levels in serum for clinical response to etanercept(ETN)treatment in patients with rheumatoid arthritis(RA).Methods This study enrolled 58 consecutive patients with active RA.All patients received ETN for 24 weeks"on demand"based on clinical need and patient request.Serum samples were obtained from each patient at baseline and biomarker levels were quantified with enzyme-linked immunosorbent assay.Results After 24 weeks,38 RA patients who achieved a clinical response were categorized as the responder group,while 20 RA patients who failed to achieve clinical response were included in the non-responder group.Baseline serum interleukin-1β(IL-1β)and interleukin-6(IL-6)levels were increased in the responder group compared to those in the non-responder group(P=0.011 and P=0.004,respectively).Receiver operating characteristic curves showed that both baseline serum IL-1β(AUC:0.703,95%CI:0.558-0.847)and IL-6(AUC:0.732,95%CI:0.601-0.862)expression had a good predictive value in distinguishing responders from non-responders.In addition,univariate and multivariate logistic regression analysis showed that high expression of IL-6 was an independent predictor of clinical response to ETN treatment(P=0.031).Conclusion Baseline IL-1βand IL-6 expression might be useful as biomarkers for predicting clinical response to ETN treatment in RA patients.

关 键 词：白细胞介素-1Β 白细胞介素-6 依那西普 类风湿关节炎 肿瘤坏死因子抑制剂 

分 类 号：R593.22[医药卫生—内科学]