白细胞介素-18与系统性红斑狼疮活动性关系探讨

Investigation of relationship between the measurement of IL-18 and disease activity in systemic lupus erythematosus

目的进一步证实系统性红斑狼疮(SLE)患者血清中IL-18的水平与SLE活动性的关系。方法采用酶联免疫吸附试验(ELISA)检测了38例SLE患者在活动期和治疗后稳定期及30例对照血清中IL-18的水平,观察IL-18与SLE疾病活动指数标准(SLEDAI)及其它疾病活动指标[血沉(ESR),抗双链-DNA(ds-DNA)抗体,补体C3和C4及总补体CH50]的相关性。结果(1)活动期和治疗后稳定期SLE患者血清中IL-18水平[分别为(754.2±314.8)pg/ml,(311.5±256.7)pg/ml]显著高于健康对照组[(108.4±12.6)pg/ml];活动期SLE患者血清中IL-18水平显著高于稳定期患者(P<0.05)。(2)在活动期SLE患者,血清中IL-18水平分别与抗ds-DNA抗体滴度和SLEDAI评分呈现显著的正相关(均P<0.05)。与ESR,C3,C4和CH50等其它实验室指标无显著相关性(均P>0.05)。而活动期SLEDAI评分分别与C3、CH50和抗ds-DNA抗体滴度呈显著的相关性(均P<0.05)。(3)活动期和治疗后稳定期SLE患者血清中IL-18水平变化结果与SLEDAI评分变化结果呈现显著相关性(r=0.46,P<0.05)。结论IL-18水平在SLE中升高,与SLE活动性呈现显著正相关,检测IL-18可以作为诊断SLE活动性的有效的指标之一。

Objective To determine the serum interleukin （IL-18）levels in patients with systemic lupus erythematosus（SLE） and to assess their relationship with disease activity. Methods IL-18 levels was determined in thirty-eight patients with SLE and thirty age-and sex-matched controls by using enzyme-linked immunoabsorbent assay （ELISA）. Their correlations with the disease activity, measured by using the SLE disease. Activity Index （SLEDAI） and laboratory parameters such as anti-dsDNA antibody, C3, C4- and CH50 were analyzed. Results （ 1 ）The serum IL-18 levels in the patients with SLE at active stage before treatment and stable stage after treatment active stage： （754.2 ± 314.8）pg/ml; stable stage： （311.5 ± 256.7）pg/ml were significantly higher than those in the controls （108.4 ± 12.6） pg/ml;The serum IL-18 levels in the patients with SLE at active stage were significantly higher than those of stable stage after treatment. （2） The IL-18 levels measured at active stage before treatment correlated well with SLEDAI score and anti-dsDNA antibody titer （P 〈 0.05）. But did not correlate with other laboratory parameters reflecting the disease activity such as C3, C4 and CH50. But SLEDAI score were correlated with C3,CH50 and anti-dsDNA antibody titer （P 〈 0.05）. （3）The changes of IL-18 levels in the patients with SLE between active stage and stable stage correlated well with those of SLEDAI （ r = 0.46, P 〈 0.05）. Conclusions The serum IL-18 levels were elevated in patients with SLE, and these increased levels correlated with SLE disease activity. The serum IL-18 level might be useful as an effective objective index to reflect the activity of SLE.