雷公藤多苷对类风湿关节炎患者血清细胞因子水平的影响

Effect of Tripterygium Glycosides on Serum Cytokines in Patients with Rheumatoid Arthritis

目的探讨雷公藤多苷对类风湿关节炎患者血清细胞因子水平的影响。方法收集滨州市中心医院2008年6月至2011年10月门诊就诊的初治类风湿关节炎患者38例,设为观察组,给予雷公藤多苷片30 mg/d,疗程3个月;对照组为同期健康体检者35例。采用放免法测定血清细胞因子白细胞介素4(IL-4)、白细胞介素6(IL-6)、白细胞介素8(IL-8)、白细胞介素10(IL-10)的水平,并结合血沉、C反应蛋白及临床表现等进行分析。结果类风湿关节炎患者治疗前血清IL-6及IL-8水平明显高于对照组(P<0.01),IL-4及IL-10水平与对照组相似(P>0.05);雷公藤多苷治疗3个月后患者血清IL-6及IL-8水平较治疗前明显降低(P<0.01),IL-4及IL-10水平较治疗前明显升高(P<0.01);38例观察组患者中,显效16例,有效16例,无效6例,总有效率为84.21%,治疗3个月后患者血沉、C反应蛋白水平均较治疗前明显降低(P<0.01)。结论类风湿关节炎患者血清IL-4,IL-6,IL-8,IL-10水平的失衡可能与其发病有关;雷公藤多苷可有效调节类风湿关节炎患者血清IL-4,IL-6,IL-8,IL-10的水平,从而发挥治疗作用。

Objective To investigate the effects of tripterygium glycosides on serum levels of cytokine IL- 4, IL- 6, IL- 8 and IL- 10 in the patients with rheumatoid arthritis（RA）. Methods Thirty-eight patients with initial RA in the outpatient clinic of this hospital from June 2008 to October 2011 were collected as the observation group and treated with oral Tripterygium Glycosides Tablet 30mg/d for 3 months. Contemporaneous 35 healthy individuals with physical examination were selected as the control group. The serum levels of cytokine IL-4,IL-6,IL-8 and IL-10 were detected by the radiation immunosorhent assay（RIA） before and after therapy. The de- tected results were analyzed in combination with ESR, CRP and the clinical manifestations. Results The serum levels of IL- 6 and IL-8 before therapy in the observation group were evidently higher than those in the control group（P〈0.01）, while the serum levels of IL-4 and IL-l0 showed no statistically significant difference compared with the control group （P〉0.05）. After 3-month thera- py, the serum levels of IL-6 and IL-8 were evidently decreased compared with those before therapy （P 〈 0.01）, while the serum levels of IL-4 and IL- 10 were increased compared with those before therapy（P 〈 0.01）. Among 38 cases in the observation group, 16 cases were excellent, 16 cases were effective and 6 cases were ineffective, the total effective rate was 84.21%. The levels of ESR and CRP after 3-month therapy were significantly decreased compared with before therapy （P 〈0.01）. Conclusion The unbalance of serum IL- 4, IL- 6, IL- 8 and IL- 10 levels in the RA patients may be related to the pathogenesis of RA. Tripterygium glycosides can exert its therapeutic effect through effectively regulating the serum levels of cytokine IL-4, IL-6, IL-8 and IL-10 in the RA patients.