NLRP3炎性小体促分泌产物IL-1β、IL-18评估RA-IP预后的临床价值

Clinical value of IL-1β and IL-18 promoted by NLRP3 inflammasome in prognosis prediction of patients with RA-IP

目的分析NLRP3炎性小体促分泌产物IL-1β、IL-18预测风湿性关节炎合并间质性肺炎(RA-IP)的能力。方法选取就诊于我院确诊为RA-IP的患者105例,治疗后登记相关资料。随访1年,根据患者随访结局分为不良组与良好组。生存曲线显示随访后的不良预后率;同时,单因素Cox、多因素Cox回归评价多个因素对RA-IP患者预后情况的影响程度;运用ROC曲线分析其对RA-IP患者预后转归的预测能力。结果单因素、多因素Cox回归显示RF-Ig M、IL-1β、IL-18对疾病治疗预后有显著影响且IL-1β影响程度最大(RR=1.624);不良组中IL-1β、IL-18显著高于良好组,RF-Ig M阳性患者人数亦显著高于良好组(χ2=4.152,P=0.042);ROC曲线下IL-1β面积相对最高,其敏感性为55.9%,特异性为86.2%。结论 IL-1β对RA-IP患者的预后有较好的预测能力。

Objective To explore the value of IL-1β and IL-18 in predicting the prognosis of patients with RA-IP. Methods One hundred and five patients diagnosed as RA-IP were involved and their baseline information were recorded. Then, all of the 105 patients were followed-up for 1 year and divided into two groups according to the outcomes of follow-up. The poor prognosis rate of patients was showed by survival curves. Single factor analysis and multiple factors Cox＇s model analysis were applied to evaluate the influencing degree of factors affecting the prognosis of RA-IP. Meanwhile, the difference of the selected factors of two groups was analyzed and the sensitivity and specificity of the factors in predicting prognosis of patients were calculated by ROC curves. Results The results of single factor analysis and multiple factors Cox＇s model analysis showed that RF-IgM IL-1β and IL-18 had influence on the prognosis of patients with RA-IP and IL- 1β was the most influential factor （RR = 1.624）. Compared with those in the favorable group, IL-1β, IL-18, and the positive numbers of RF-IgM（χ^2 = 4.152, P = 0.042） in the unfavorable group were higher. The ROC analysis showed that the AUC of IL - 1β was the highest, and the sensitivity and specificity were 55.9% and 86.2%, respectively. Conclusion IL -1β may assess the prog- nosis of patients with RA-IP.