摘要
目的探讨系统性红斑狼疮(SLE)患者血清细胞因子水平变化及临床意义。方法选取2018年4月至2019年4月于宜昌市中心人民医院就诊的32例SLE患者作为观察组,选取同时期进行健康体检的32名健康者作为对照组,观察组根据SLE疾病活动指数(SLEDAI)评分分为稳定组(SLEDAI评分<10分)和活动组(SLEDAI评分≥10分),每组16例。比较各组的血清细胞因子[白细胞介素(IL)-17、IL-10、IL-23、肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)]水平,并对SLE患者的双链DNA(ds-DNA)、C反应蛋白(CRP)、红细胞沉降率(ESR)水平与血清细胞因子水平进行相关性分析。结果观察组的血清IL-17、IL-10、IL-23、TNF-α、IFN-γ水平均高于对照组[(207.4±58.1)ng/L比(76.3±18.5)ng/L,(77.2±19.8)ng/L比(17.8±5.2)ng/L,(177.4±45.3)ng/L比(41.0±12.0)ng/L,(392.9±108.6)μg/L比(232.0±66.9)μg/L,(21.8±5.8)ng/L比(11.2±2.2)ng/L](P<0.05)。活动组、稳定组的血清IL-17、IL-10、IL-23、TNF-α、IFN-γ水平均高于对照组(P<0.05),且活动组高于稳定组[(237.2±70.6)ng/L比(171.2±51.0)ng/L,(96.8±21.8)ng/L比(42.4±12.2)ng/L,(191.0±55.3)ng/L比(122.1±34.6)ng/L,(483.9±124.2)μg/L比(354.1±101.3)μg/L,(24.8±7.2)ng/L比(17.8±5.0)ng/L](P<0.05)。SLE患者的血清IL-10与ds-DNA、CRP、ESR呈正相关,IL-17、IL-23、IL-10与SLEDAI呈正相关。结论SLE患者的血清IL-17、IL-10、IL-23、TNF-α、IFN-γ均异常表达,其中IL-17、IL-10、IL-23与疾病病程相关,故IL-10可成为预测SLE患者疾病活动度的生物标志物。
Objective To explore the changes of serum cytokines in patients with systemic lupus erythematosus(SLE)and its clinical significance.Methods A total of 32 patients with SLE treated in Yichang Central People′s Hospital from Apr.2018 to Apr.2019 were included as an observation group,and 32 healthy people who had physical examination during the same period were included as a control group.According to the SLE disease activity index(SLEDAI),the observation group was divided into a stable group(SLEDAI score<10)and an active group(SLEDAI score≥10),16 cases each.The levels of serum cytokines[interleukin(IL)-17,IL-10,IL-23,tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)]in each group were compared,and the correlation between the levels of double-stranded DNA(dsDNA),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and serum cytokines were analyzed.Results The serum levels of IL-17,IL-10,IL-23,TNF-αand IFN-γin the observation group were higher than those in the control group[(207.4±58.1)ng/L vs(76.3±18.5)ng/L,(77.2±19.8)ng/L vs(17.8±5.2)ng/L,(177.4±45.3)ng/L vs(41.0±12.0)ng/L,(392.9±108.6)μg/L vs(232.0±66.9)μg/L,(21.8±5.8)ng/L vs(11.2±2.2)ng/L](P<0.05).The serum levels of IL-17,IL-10,IL-23,TNF-αand IFN-γin the active group and the stable group were higher than those in the control group(P<0.05),and the active group higher than the stable group[(237.2±70.6)ng/L vs(171.2±51.0)ng/L,(96.8±21.8)ng/L vs(42.4±12.2)ng/L,(191.0±55.3)ng/L vs(122.1±34.6)ng/L,(483.9±124.2)μg/L vs(354.1±101.3)μg/L,(24.8±7.2)ng/L vs(17.8±5.0)ng/L](P<0.05).Serum IL-10 was positively correlated with ds-DNA,CRP and ESR,while IL-17,IL-23 and IL-10 were positively correlated with SLEDAI.Conclusion The expressions of IL-17,IL-10,IL-23,TNF-αand IFN-γin sera of patients with SLE are abnormal,in which IL-17,IL-10 and IL-23 are associated with the course of the disease,and IL-10 can be a biomarker for predicting the disease activity in SLE patients.
作者
罗春华
李鹏
李乾元
赵武
汪作新
LUO Chunhua;LI Peng;LI Qianyuan;ZHAO Wu;WANG Zuoxin(Department of Clinical Laboratory,Yichang Central People′s Hospital,Yichang 443003,China)
出处
《医学综述》
2020年第8期1641-1644,1649,共5页
Medical Recapitulate
作者简介
通信作者:汪作新,Email:lchlgj2004@aliyun.com。
