系统性红斑狼疮患者外周血干扰素α、白介素6和肿瘤坏死因子α水平

Levels of Interferon α、Interlenkin 6 and Tumor Necrosis Factor α in Serum of Patients with Systemic Lupus Erythematosus

目的检测系统性红斑狼疮(SLE)患者血清中干扰素α(interferon α,IFN-α)、白介素6(interleukin 6,IL-6)和肿瘤坏死因子α(tumor necrosis factorα,TNF-α)的水平,探讨其在SLE中的作用。方法采用酶联免疫吸附法检测SLE患者及正常对照者血清IFN-α、IL-6及TNF-α水平;分析其与SLE实验室指标及临床表现的相关性。结果 SLE患者外周血中IFN-α、IL-6水平显著高于正常对照组,差异均有统计学意义[(4.99±7.47)ng/Lvs.(2.07±1.98)ng/L,(4.36±7.62)ng/Lvs.(1.72±2.87)ng/L,均P<0.05];其中活动期SLE患者IFN-α水平明显高于稳定期,差异有统计学意义[(9.79±12.04)ng/Lvs.(3.13±3.47)ng/L,P<0.05]。SLE患者血红蛋白减低组血清IFN-α水平显著高于血红蛋白正常组,差异有统计学意义[(5.34±6.36)ng/Lvs.(2.84±3.58)ng/L,P<0.05];抗双链DNA抗体阳性患者血清IFN-α、IL-6水平明显高于阴性者,差异均有统计学意义[(7.35±8.12)ng/Lvs.(4.22±8.11)ng/L,(10.26±12.76)ng/Lvs.(2.37±1.61)ng/L,均P<0.05]。SLE患者血清IFN-α水平与TNF-α、SLE疾病活动指数积分、抗双链DNA抗体呈正相关(r=0.303,P<0.05;r=0.427,P<0.01;r=0.368,P<0.05),与血红蛋白水平呈负相关(r=-0.345,P<0.05);IL-6水平与血细胞沉降率、抗双链DNA抗体呈正相关(r=0.526,P<0.01;r=0.437,P<0.05)。SLE患者血清IFN-α水平在有血液系统受累患者中表达水平明显升高,差异有统计学意义(P<0.05);血清IL-6水平在伴有发热、关节炎或血液系统损害的患者中明显高于无上述临床表现的患者,差异具有统计学意义(P<0.01或P<0.05)。结论 SLE患者外周血细胞因子分泌存在异常,各细胞因子相互作用,共同参与疾病的发生与发展。

Objective To detect the serum levels of interferon α （IFN-α）, interlenkin 6 （IL-6） and tumor necrosis factor α （TNF-α） and explore the pathogenesis of cytokines in systemic lupus erythematosus （SLE）. Methods The serum levels of IFN-α, IL-6 and TNF-α were measured by ELISA assay in SLE patients and normal controls. The correlations between laboratory parameters and clinical manifestations were evaluated. Results The serum levels of IFN-α, IL-6 in patients with SLE were significantly higher as compared with those in normal controls [ （4. 99 ± 7.47 ） ng/L vs. （2. 07 ± 1.98 ） ng/L, （4. 36 ± 7.62 ） ng/L vs. （ 1.72 ± 2. 87） ng/L, bαh P 〈 0. 051-The level of IFN-α in patients with active disease was significantly higher than that in patients with inactive disease [ （9.79 ± 12.04） ng/L vs. （3.13 ± 3.47） ng/L, P 〈 0.05 ]. The serum IFN-α level in patients with anemia was significantly elevated eompared to those with normal hemoglobin [ （5.34 ± 6.36） ng/L vs. （2. 84 ± 3.58） ng/L, P 〈 0. 05 ]. Patients with positive anti-dsDNA antibody had significantly higher serum levels of IFN-α and IL-6 than those with negative anti-dsDNA antibody [ （7.35 ±8.12） ng/L vs. （4.22 ±8.11 ） ng/L, （ 10.26 ± 12.76） ng/L vs. （2. 37 ± 1.61 ） ng/L, bαh P 〈0. 05 ]. The serum level of IFN-α in SLE was positively correlated with TNF-α, SLEDAI score and anti-dsDNA antibody （r =0. 303, P 〈0.05; r =0. 427, P 〈0. 01 ; r =0. 368, P 〈 0. 05 ） , and negatively correlated with hemoglobin （ r = - 0. 345, P 〈 0. 05 ）. The serum level of IL-6 was positively correlated with ESR and anti-dsDNA antibody （r = 0.526, P 〈 0.01 ; r = 0. 437, P 〈 0.05 ）. The serum level of IFN-α was significantly increased in patients with hematological system involvement （P 〈 0. 05 ）, and the level of IL-6 was significantly increased in patients with fever, arthritis and hematological system involvement in eomparison with the patients without these manifestations （ P 〈 0. 01 or P 〈 0. 05 ）. Conclusion The cytokines in peripheral blood of SLE are abnormally seereted, which may interact with eaeh αher and participate in the onset and progression of the disease.