强直性脊柱炎sICAM-1、sVCAM-1水平变化与中医证型相关性研究

Study on the Correlativity between TCM Syndrome Types and Changes of sICAM-1 and sVCAM-1 in Ankylosing Spondylitis Patients

目的观察强直性脊柱炎(AS)患者血清中可溶性细胞间粘附分子(sICAM-1)、可溶性血管细胞粘附分子(sVCAM-1)水平的变化,并探讨与中医证型的相关性。方法用酶联免疫吸附试验(ELISA)检测68例活动性AS患者与20名健康对照者的血清。结果68例患者血清中sICAM-1表达明显高于健康对照组(P<0.001),各中医证型与健康对照组均有显著性差异(P<0.001),水平趋势为肾虚督寒证>邪及肝肺证>邪痹肢节证,但各证型组间无显著性差异。sVCAM-1表达与健康对照组之间无显著性差异(P>0.05),其中仅邪及肝肺证与健康对照组有显著性差异(P<0.05),并与肾虚督寒证有显著性差异(P<0.05)。结论sICAM-1、sVCAM-1可能参与了AS病变过程,与中医的辨证分型具有一定的相关性,它们的血清变化水平可作为AS中医辨证分型的辅助客观指标。

Objective To observe the changes of soluble intercellular adhesion molecule-1 （sICAM-1） and soluble vascular cell adhesion molecule-1 （sVCAM-1） in patients with ankylosing spondylitis, and further investigate the correlativity with TCM syndrome types. Methods The serum expression levels of sICAM-1 and sVCAM-1 were detected by ELISA in sixty-eight ankylosing spondylitis patients and twenty healthy subjects as control. Results Serum level of sICAM-1 expression in 68 ankylosing spondylitis patients and each type of syndromes was significantly higher than that in healthy subjects （P〈0.001）. And the level change tendency： Kidney deficiency and Du cold type （KDDC）〉Pathogenic factors invade liver and lung type （PILL）〉pathogenic factors close limbs type （PCLT）, however, there was no significant difference among the three type groups. Serum level of sVCAM- 1 expression was not significantly higher than that in healthy subjects （P〉0.05）. Only the sVCAM-1 level of PILL type had significant difference with the healthy control group and KDDC type （P〈0.05）. Conclusion The expression of sICAM-1 and sVCAM-1 may be involved in the pathological development of ankylosing spondylitis, which was related to TCM syndrome types. The serum change levels of sICAM-1 and sVACM-1 may serve as an assistant objective maker of TCM syndrome differentiation in ankylosing spondylitis patients.