活动性强直性脊柱炎患者外周血MIF、IL-23、RANKL、OPG和DKK1检测的临床意义

Clinical significance of detection of MIF,IL-23,RANKL,OPG and DKK1 in peripheral blood of patients with active ankylosing spondylitis

目的探讨活动性强直性脊柱炎(ankylosing spondylitis,AS)患者外周血巨噬细胞移动抑制因子(MIF)、白细胞介素-23(IL-23)、核因子κB受体活化因子配体(RANKL)、骨保护素(OPG)、Dickkopf-1(DKK1)检测的临床意义。方法选取2013年2月至2016年1月风湿免疫科住院并治疗的AS患者46例为观察组,另选取同期行体检健康者38例为对照组。观察组于入院首日清晨空腹经肘静脉采集血,对照组取体检血样,检测2组外周血中MIF、IL-23、RANKL、OPG、DKK1水平,以及ESR及CRP水平,并进一步分析观察组外周血MIF、IL-23、RANKL、OPG、DKK1水平与疾病活动的相关性。结果观察组外周血MIF(25.38±11.05)ng/ml、IL-23(374.90±38.19)pg/L、RANKL(21.53±17.44)pg/ml、OPG(5.04±1.65)pg/ml、DKK1(0.71±0.16)ng/ml水平均高于对照组的(4.02±0.83)ng/ml、(179.82±21.76)pg/L、(7.62±1.24)pg/ml、(1.89±0.32)pg/ml、(0.13±0.04)ng/ml,差异均有统计学意义(P<0.01);观察组患者外周血ESR(40.25±29.79)mm/h及CRP(4.78±3.40)mg/L水平显著高于对照组的(8.27±0.49)mm/h、(2.61±0.35)mg/L,差异均有统计学意义(P<0.01)。相关分析结果显示:观察组患者外周血MIF、IL-23、OPG含量均与疾病活动因子ESR、CRP水平呈正相关(P<0.05),RANKL、DKK1与疾病活动因子ESR、CRP水平无明显相关性(P>0.05)。结论活动性强直性脊柱炎患者外周血中MIF、IL-23、RANKL、OPG、DKK1水平显著上升,且MIF、IL-23、RANKL上升幅度与疾病活动性呈正相关,借此可对疾病的严重度及治疗效果做出客观评估。

Objective To investigate the clinical significance of detection of macrophage migration inhibitory factor（ MIF）,interleukin-23（ IL-23）,receptor activator of nuclear factor kappa B ligand（ RANKL）,osteoprotegerin（ OPG）,Dickkopf-1（ DKK1） in peripheral blood of patients with active ankylosing spondylitis（ AS）. Methods Forty-six patients with AS who were admitted and treated in our hospital from February 2013 to January 2016 were enrolled as observation group,at the same time,the other 38 healthy subjects were enrolled as control group. The blood specimens were collected in patients of both groups,then the levels of MIF,IL-23,RANKL,OPG,DKK1,ESR and CRP in peripheral blood of patients were detected,moreover,the correlation between the levels of these indexes and disease activity was analyzed. Results The levels of MIF（ 25. 38 ± 11. 05） ng/ml,IL-23（ 374. 90 ± 38. 19） pg/L,RANKL（ 21. 53 ± 17. 44） pg/ml,OPG（ 5. 04 ± 1. 65） pg/ml,DKK1（ 0. 71 ± 0. 16） ng/ml in observation group were significantly higher than those in control group（ 4. 02 ± 0. 83） ng/ml,（ 179. 82 ± 21. 76） pg/L.（ 7. 62 ± 1. 24） pg/ml,（ 1. 89 ± 0. 32） pg/ml,（ 0. 13 ± 0. 04） ng/ml,respctively（ P〈0. 01）.Moreover the levels of ESR（ 40. 25 ± 29. 79） mm/h and CRP（ 4. 78 ± 3. 40） mg/L in observation group were also significantly higher than those in control group（ 8. 27 ± 0. 49） mm/h,（ 2. 61 ± 0. 35） mg/L,respectively（ P〈0. 01）. The correlation analysis results showed that the levels of MIF,OPG,IL-23 in observation group were positively correlated to those of ESR,CRP（ P〈0. 05）,however,the levels of RANKL and DKK1 were not correlated with those ESR and CRP（ P〉0. 05）.Conclusion The levels of MIF,IL-23,RANKL,OPG,DKK1 in peripheral blood of patients with active ankylosing spondylitis are obviously increased,moreover,the increase degree of MIF,IL-23,RANKL is positively correlated to disease activity,thereby,which can evaluate the severity of disease and therapeutic effects objectively.