强直性脊柱炎呼吸道感染患者细胞因子水平及其与疾病活动度的相关性  

Change of cytokines of ankylosing spondylitis patients with respiratory tract infection and its association with disease activity

作　　者：郝艳萍[1] 萨仁娜[1] 王雅菲[1] 张永梅[1] 周银锁[1] 托娅[1] HAO Yan-ping;SA Ren-na;WANG Ya-fei;ZHANG Yong-mei;ZHOU Yin-suo;TUO Ya(Affiliated Hospital of Neimenggu Medical University,Hohhot,Inner Mongolia 010000,China)

机构地区：[1]内蒙古医科大学附属医院检验科,内蒙古呼和浩特010000

出　　处：《中华医院感染学杂志》2020年第17期2679-2682,共4页Chinese Journal of Nosocomiology

基　　金：内蒙古医科大学附属医院重大科研项目(NYFY-ZD-005);内蒙古医科大学附属医院一般科研项目(NYFY-YB-038)。

摘　　要：目的 分析呼吸道感染对强直性脊柱炎(Ankylosing spondylitis,AS)患者细胞因子水平变化及其与疾病活动度的相关性.方法 选取2016年1月-2018年12月就诊于内蒙古医科大学附属医院风湿科的86例AS患者,行Bath强直性脊柱炎病情活动指数评分(BASDAI)后按就诊前是否发生呼吸道感染分为感染组29例与非感染组57例,比较两组患者血沉(ESR)、C-反应蛋白(CRP)的水平变化.流式细胞仪检测外周血Th1、Th2细胞比例,酶联免疫法测定T细胞亚群相关细胞因子干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)、白介素-10(IL-10)水平.结果 感染组患者ESR、CRP、BASDI评分均高于非感染组(P<0.05);感染组Th1细胞比例高于非感染组,Th2细胞比例低于非感染组(P<0.05),IFN-γ、TNF-α、IL-4、IL-10水平均高于非感染组(P<0.05);Th1、IFN-γ、TNF-α与AS伴呼吸道感染患者BASDI评分呈正相关(P<0.05),Th2与BASDI评分呈负相关(P<0.05).结论 呼吸道感染可能通过介导Th1/Th2免疫失衡及炎症反应等途径增加AS患者活动度,加重机体免疫紊乱.OBJECTIVE To analyze the changes of cytokines of the ankylosing spondylitis(AS)patients with respiratory tract infection and its association with disease activity.METHODS A total of 86 AS patients who were treated in rheumatology department of Affiliated Hospital of Neimenggu Medical University from Jan 2016 to Dec 2018 were enrolled in the study and divided into the infection group with 29 cases and the non-infection group with 57 cases on basis of the fact that whether the respiratory tract infection occurred after Bath ankylosing spondylitis disease activity index(BASDAI)scoring was performed.The erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were compared between the two groups of patients,the percentages of peripheral blood Th1 and Th2 cells were detected by using flow cytometry,and the levels of T cell subtest-associated cytokines interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-4(IL-4)and interleukin-10(IL-10)were detected by means of enzyme-linked immunosorbent assay.RESULTS The ESR,CRP and BASDI score were significantly higher in the infection group than in the non-infection group(P<0.05);the percentage of Th1 cell of the infection group was higher than that of the non-infection group,and the percentage of Th1 cell of the infection group was significantly lower than that of the non-infection group(P<0.05);the levels of IFN-γ,TNF-α,IL-4 and IL-10 of the infection group were significantly higher than those of the non-infection group(P<0.05);the Th1,IFN-γand TNF-αwere positively correlated with the BASDI score of the AS patients complicated with respiratory tract infection(P<0.05),and the Th2 was negatively correlated with the BASDI score(P<0.05).CONCLUSION Respiratory tract infection may increase the activity of the AS patients and aggravate immune disorder of body by mediating Th1/Th2 immune imbalance and inflammatory response.

关 键 词：强直性脊柱炎 呼吸道感染 疾病活动度 T细胞亚群 细胞因子 流式细胞术 

分 类 号：R56[医药卫生—呼吸系统]