肛瘘患者外周血清炎症细胞因子IL-6和IL-17A表达水平及其在发病中的作用

The serum level of inflammatory cytokines IL-6 and IL-17A and its clinical significance in patients with anal fistula

目的:研究炎症因子IL-6、IL-17A在肛瘘患者外周血清中的表达水平,分析其在肛瘘发病中的作用。方法:选择49例肛瘘患者(肛瘘组)和48例健康体检者(对照组)血清,用化学发光法检测肿瘤标志物CA199,用微量样本多重蛋白定量技术(CBA)测定外周血清中IL-6、IL-17A水平。肛瘘壁病理检查采用HE染色,肛瘘脓液细菌培养根据《全国临床检验操作规程》对病原微生物进行培养鉴定。结果:肛瘘组外周血清IL-6水平明显高于对照组,2组比较差异有统计学意义(P<0.05)。病理检查示肛瘘组外周血清IL-6和IL-17A表达水平增高者,肛瘘壁出现大量淋巴细胞浸润。肛瘘中存在脓液及脓液细菌培养阳性的患者IL-6水平明显高于肛瘘中无脓液及脓液细菌培养阴性的患者,差异有统计学意义(P=0.008、0.001)。结论:肛瘘患者外周血清IL-6和IL-17A表达水平增高与局部淋巴细胞浸润有关,IL-6还与肛瘘是否有脓液相关,动态监测外周血清IL-6和IL-17A水平对评估肛瘘患者的病情有一定临床价值。

Objective:To investigate the serum level of inflammatory cytokines IL-6 and IL-17A and its clinical significance in patients with anal fistula.Methods:The serum levels of IL-6 and IL-17A cytokines of 49 patients with anorectal fistula and 48 healthy controls were detected by using cytometric bead array technology(CBA).The relationship between serum levels of cytokines and clinical characteristics was also analyzed.The pathological sections of anal fistula were stained with HE,and the bacteria in anal fistula was cultured according to the National Clinical Laboratory Procedures.Results:The serum level of IL-6 in patients with anal fistula was significantly higher than that in healthy controls(P<0.05).Moreover,pathological analysis indicated that the mucous membrane of anal fistula presents large number of lymphocyte infiltration in patients with high serum level of IL-6 and IL-17A.Patients with pus or pus germiculture positive had obviously higher IL-6 level than that in patients without pus or germiculture negative(P=0.008,0.001).Conclusion:Patients with anal fistula have higher serum levels of IL-6 and IL-17A,which is associated with local mucous lymphocytic infiltration.Moreover,IL-6 level is correlated to anal fistula pus.Dynamic monitoring of the serum levels of IL-6 and IL-17A may produce clinical significance to evaluate the condition of patients with anal fistula.