氧化应激及白细胞介素1β在痛风性关节炎中的作用及丙丁酚对其影响

Oxidative stress and interleukin-1β in acute gouty arthritis and the efficacy of probucol treatment

目的探讨丙二醛、超氧化物歧化酶（SOD）、白细胞介素1β（IL-1β）在急性痛风性关节炎发病中的作用及丙丁酚的治疗作用。方法在大鼠单侧踝关节腔内注射尿酸钠晶体建立急性痛风性关节炎模型，观察各组不同时间关节肿胀指数的变化及丙丁酚干预72h后关节液中一些炎症介质和白细胞计数的变化。结果造模后关节肿胀指数逐渐增高，11h后达高峰。丙丁酚高剂量组48h时关节肿胀指数明显低于模型组（P〈0．05），72h中高剂量组低于模型组（P〈0．05）。中高剂量组丙二醛含量分别为（14．45±3．11）和（11．54±3．10）nmoL／ml，与模型组（24．46±4．27）nmol／ml比较明显下降（P〈0．01）；中高剂量组SOD含量分别为（25．56±4．51）和（44．61±4．11）U／ml，与模型组（13．32±2．02）U／ml比较明显升高（P〈0．01）；高剂量组IL-1β含量为（15．41±3．12）Pg，较模型组（19．87±3．99）pg明显下降（P〈0．05）；中高剂量组白细胞计数分别为（11．08±1．64）×10^7／L和（7．43±1．52）×10^7／L，较模型组（14．18±2．30）×10^7／L明显下降（P〈0．01）。结论急性痛风性关节炎发病中丙二醛、IL-1β明显升高，SOD明显降低。中高剂量丙丁酚能有效控制急性痛风性关节炎的发作。且高剂量组疗效与秋水仙碱组疗效相当。

Objective To investigate the role of malondialdehyde （ MDA）, superoxide dismutase （ SOD ）, and interleukin-1β （IL-1β） played in the pathogenesis of acute gouty arthritis and the treatment efficacy of probucol. Methods Acute gouty arthritis model in rat was established with injection of monosodium urate monohydrate（MSU） into the ankle joint cavity, then the joint swelling index was observed periodically, and MDA, SOD, IL-1β, and white blood cell count in the synovial fluid were determined by 72 h. Results The joint swelling index gradually increased, reaching a peak by 11 h, and this finding was most obvious in the model group. The joint swelling index in the group treated with high-dose of probucol was significantly lower than that in the model group by 48 h （P〈0.05）. The joint swelling indices in the groups treated with moderate and high doses of probucol were lower than that in the model group by 72 h（P〈0.05）. The values of MDA in the moderate and high-dose groups were （ 14.45±3.11 ） and （ 11.54 ±3.10） nmol/ml respectively, being significantly lower than that in the model group [ （24.46±4.27）nmol/ml, P〈0.01 ]. The amounts of SOD in the moderate and high-dose groups were （ 25.56±4.51 ） and （44.61 ±4.11 ） U/ml respectively, being higher than that in the model group [ （ 13.32±2.02 ） U/ml,P〈0.01 ]. The amount of IL-1β in the high-dose group was lower than that in the model group [ （ 15.41± 3.12 vs 19.87± 3.99 ） pg, P〈0.05 ]. The white blood cell counts in the moderate and high-dose groups were （11.08±1.64）×10^7/L and （7.43±1.52）×10^7/L, being lower than that in the model group[ （14.18±2.30）×10^7/L,P〈0.01 ]. Conclusion The levels of MDA and IL-1β in the synovial fluid were raised, while SOD was significantly decreased in acute gouty arthritis. Moderate and high-doses of probucol can effectively control acute gouty arthritis attack. The efficacy of high-dose probucol was equal to that of colchicines.