强直性脊柱炎患者血清白细胞介素18检测的意义

Clinical significance of serum interleukin-18 in ankyiosing spondylitis

目的探讨白细胞介素18（IL-18）在强直性脊柱炎（As）发病中的作用及其血清水平检测的临床意义。方法采用酶联免疫吸附试验法（ELISA）检测53例活动期As患者与40例健康对照组血清IL-18及肿瘤坏死因子α（TNF-α）的水平，并动态观察治疗前后IL-18及TNF-α的变化及其与病情活动指标之间的关系。结果AS患者治疗前血清IL-18水平明显高于健康对照组[（415．7±30．4）ng／L比（45．7±10．4）ng／L，P〈0．05）]，并与TNF-α、Bath强直性脊柱炎病情活动性指数（BASDAI）、晨僵时间、Bath强直性脊柱炎功能指数（BASFI）和Bath强直性脊柱炎脊柱活动测量指数（BASMI）呈正相关（r分别为0．52、0．63、0．48、0．58和0．48，P均〈0．01）。治疗12周、24周后As患者血清IL-18水平分别为（323．6±85．8）和（220．1±15．1）ng／L，均较治疗前明显下降，且治疗24周后下降更明显。结论IL-18可能参与AS发病机制，血清IL-18的检测可作为反映AS病情活动的指标之一。

Objective To explore the role of IL-18 in pathogenesis of ankylosing spondylitis （AS） and clinical significance of serum IL-18 in patients with active AS before and after treatment. Methods Serum IL-18 and TNF-α levels were detected in 53 patients with active AS and 40 matched healthy controls by ELISA. Follow-up of serum IL-18 and TNF-α after treatment was accomplished and their possible relationship with disease activity index of AS was investigated. Results Serum IL-18 level before treatment was significantly higher in AS patients than that in control [ （415.7± 30.4） vs （45.7± 10.4） ng/L, P 〈 0.05 ] and was positively correlated with serum TNF-α level, BASDAI, duration of morning stiffness, BASFI and BASMI （r = 0. 52,0. 63 ,0. 48 ,0. 58 and 0.48 ,all P 〈0.01 ）. Serum IL-18 level was decreased significantly after 12 and 24 weeks of treatment[ （323.6 ± 85.8） ,（220. 1 ± 15.1 ） ng/L,P 〈0.05] ,especially after 24 weeks. Conclusion IL-18 may be involved in the pathogenesis of AS and the detection of serum IL-18 may be a possible index for disease activity in AS patients.