原发性痛风性关节炎患者白介素-1β的变化及其临床意义

Altered expression of IL-1 β in peripheral blood from gout patients and its association with gouty arthritis

目的 探讨IL-1β在痛风发病中的作用.方法 采用实时荧光定量聚合酶链反应（RT-qPCR）和酶链免疫吸附实验（ELISA）方法,检测120例痛风性关节炎急性期患者（急性期组）、70例慢性期患者（慢性期组）、80例间歇期患者（间歇期组）和96名健康体检者（正常对照组）的外周血单个核细胞（PBMCs） IL-1β mRNA水平和血浆IL-1β浓度;变量间差异采用方差分析或t检验（校正t检验）,变量间相关关系采用Spearman相关分析.结果 各组患者的PBMCs IL-1β mRNA和血浆IL-1β浓度均显著高于正常对照组（均P＜0.01）;急性期组PBMCs IL-1β mRNA和血浆IL-1β浓度显著高于慢性期和间歇期组（均P＜0.01）,慢性期组显著高于间歇期组（均P＜0.01）.患者血浆IL-1β浓度与外周血白细胞计数、中性粒细胞和单核细胞绝对计数、血尿酸、球蛋白、ESR及PBMCs IL-1βmRNA水平均呈显著正相关（均P＜0.01）,而与载脂蛋白A1呈负相关（P＜0.05）.结论 血浆IL-1β显著升高在痛风急慢性关节炎炎症机制中发挥着重要作用.

Objective To explore the role of interleukin （IL）-1β in the pathogenesis of gout.Methods Real-time quantitative polymerase chain reaction （RT-qPCR） and enzyme-linked immunosorbent assay（ELISA） were used to measure the expression of IL-1β mRNA in peripheral blood mononuclear cells （PBMCs） and IL-1β in plasma samples from 120 acute gouty （AG） arthritis,70 chronic gouty （CG） arthritis,80 intercritical gouty （IG） arthritis patients and 96 healthy control subjects respectively.Results The expression of PBMCs IL-1β mRNA and plasma concentration of IL-1β were both much higher in gout patients than those in controls （P 〈 0.01,respectively）.And the plasma levels of IL-1β mRNA and IL-1β significantly increased in the AG group compared with CG and IG groups （P 〈 0.01,respectively） and much higher in the CG group than those in the IG group.Positive correlations existed between plasma concentration of IL-1β and the levels of white blood cell,neutrophil,monocyte,erythrocyte sedimentation rate,blood uric acid,globulin and PBMCs IL-1β mRNA （P 〈 0.01,respectively） while negative correlation between plasma IL-1β and plasma level of apolipoprotein in gout patients （P 〈 0.05）.Conclusion Elevated plasma level of IL-1β may be involved in the pathogenesis of acute and chronic gouty arthritis.