IL-1β、IL-6、TNF-α与急性痛风性关节炎的相关性研究

Correlation between IL-1β,IL-6,TNF-alpha and Acute Gouty Arthritis

目的:探讨血清及关节液白介素(interleukin IL):IL-1β、IL-6,肿瘤坏死因子(tumor necrosis factor TNF):TNF-α与急性痛风性关节炎的相关性。方法:收集我院急性痛风性关节炎(GA)病人100例,同期纳入骨关节炎(OA)病人100例,分别收集其临床症状,VAS评分,并同期检测其血清和关节液IL-1β、IL-6、TNF-α水平,采用T检验分析比较两组之间的差异,以及Spearman相关分析探讨其炎症指标水平与GA临床指标的相关性。结果:1GA组较OA组血清尿酸,关节液尿酸,尿尿酸、IL-1β,IL-6,TNF-α较OA组高;2GA患者血清及关节液IL-1β与病程、入院时VAS评分、关节液尿酸及血清尿酸水平均呈正相关;3GA组血清及关节液IL-6与病程、入院时VAS评分、关节液尿酸及血清尿酸水平、CRP、ESR呈正相关、与股骨颈骨密度T值呈负相关;4血清及关节液TNF-α与关节液尿酸、血清尿酸呈正相关;5GA患者治疗2周后,血清IL-1β、TNF-α、IL-6与入院时差值与VAS评分差值、关节液尿酸差值及血清尿酸差值呈正相关;6血清IL-1β差值与血肌酐差值呈正相关,血清IL-6差值与CRP差值、ESR差值呈正相关。结论:血清及关节液IL-1β、IL-6、TNF-α在急性痛风性关节炎中明显升高,并与关节液、血清尿酸水平相关。

Objective：To investigate the correlation between serum and synovial fluid interleukin IL-1β、IL-6, tumor nec- rosis factor-alpha （TNF-α） and acute gouty arthritis （GA）. Methods：The clinical data of 100 GA and osteoarthritis （OA） patients were collected. The clinical symptoms, VAS score, and the serum and synovial fluid IL-1β、IL-6、TNF-α levels were compared using T-test analysis and spearman correlation analysis. Results：① There were significant differences in ser- um acid, joint fluid acid, uric acid,IL-1β、IL-6 and TNF-a between GA group and OA group （all P〈0.05）. ②The levels of of IL-1β in serum and synovial fluid in GA group were positively correlated with the course of disease, VAS score on ad- mission, joint fluid and serum uric acid. ③The levels of of IL-6 in serum and synovial fluid in GA group were positively correlated with the course of disease, VAS score on admission, joint fluid and serum uric acid, CRP, and ESR, but nega- tively correlated with T-values of femoral neck bone mineral density. ④There was positive correlation between TNF-a in serum and synovial fluid and uric acid in synovial fluid and serum. ⑤After two weeks treatment, serum I1.-113, TNF-a and II76 were positively correlated with the differences of VAS score, joint fluid uric acid and serum uric acid in GA patients. ⑥Serum II.-113 difference was positively correlated with serum creatinine difference, while serum IL-6 difference with CRP difference as well as ESR difference. Conclusion：The serum and synovial fluid IL-1β、IL-6, and TNF-α were significantly increased in acute gouty arthritis, and correlated with uric acid levels in synovial fluid and serum.