血清IL-28A和HMGB1在强直性脊柱炎中的表达及与疾病活动和疗效的关系

The expression of serum IL-28A and HMGB1 in ankylosing spondylitis and its relationship with disease activity and curative effect

目的:探讨血清白细胞介素28A(IL-28A)和血清高迁移率族蛋白B1(HMGB1)在强直性脊柱炎中的表达情况,并分析其与疾病活动及疗效的关系。方法:95例强直性脊柱炎患者,根据ASDAS-CRP将其分为活动组(n=60)和稳定组(n=35),同期选取70名健康体检者作为对照组。采用酶联免疫吸附法(ELISA)检测血清IL-28A和HMGB1水平,并比较各组差异,绘制ROC曲线分析血清IL-28A和HMGB1检测对强直性脊柱炎的诊断效能;比较不同活动度强直性脊柱炎患者血清IL-28A和HMGB1差异,并用Pearson法分析其关系;比较治疗前后各组血清IL-28A和HMGB1水平以评估疗效。结果:治疗前,活动组、稳定组和对照组血清IL-28A和HMGB1水平比较,差异有统计学意义(F=18.192,P=0.001;F=39.437,P<0.001);绘制ROC曲线,与单项检测比较,血清IL-28A和HMGB两者联合检测明显提高了AS特异度和敏感度;治疗前,低度活动者、中度活动者和高度活动者血清IL-28A和HMGB1水平比较,差异有统计学意义(F=14.627,P<0.001;F=8.342,P<0.001);经Pearson法分析得知,血清IL-28A和HMGB1与ASDAS-CRP值均呈正相关(r=0.675,P=0.024;r=0.704,P=0.011);与治疗前比较,治疗后活动组血清IL-28A和HMGB1均明显降低,且差异有统计学意义(t=16.483,P<0.001;t=10.682,P=0.001)。结论:血清IL-28A和HMGB1在AS中高表达,与疾病活动度呈正相关,在AS诊断及疗效评估上有一定价值。

Objective:To investigate the expression of serum interleukin-28A(IL-28A)and high mobility group protein B1(HMGB1)in ankylosing spondylitis(AS),and to analyze their relationship with disease activity and therapeutic effect.Methods:95 patients with ankylosing spondylitis were selected as the study subjects.According to ASDAS-CRP,they were divided into active group(n=60)and stable group(n=35).70 healthy people were selected as the control group during the same period.The serum levels of IL-28A and HMGB1 were detected by ELISA and the differences between groups were compared.The ROC curve was drawn to analyze the diagnostic efficacy of serum IL-28A and HMGB1 in ankylosing spondylitis.The differences of serum IL-28A and HMGB1 in patients with ankylosing spondylitis of different activity were compared and the relationship between them was analyzed by Pearson method.The serum levels of IL-28A and HMGB1 in each group before and after treatment were compared to evaluate the curative effect.Results:Before treatment,the levels of serum IL-28A and HMGB1 in active group,stable group and control group were significantly different(F=18.192,P=0.001&F=39.437,P<0.001).The ROC curve was drawn,compared with the single test,the combined detection of serum IL-28A and HMGB significantly improved the specificity and sensitivity of AS.There were significant differences in serum IL-28A and HMGB1 levels among low,moderate and high levels of activity before treatment(F=14.627,P<0.001&F=8.342,P<0.001).The Pearson analysis showed that serum IL-28A and HMGB1 were positively correlated with ASDAS-CRP(r=0.675,P=0.024&r=0.704,P=0.011),compared with pre-treatment,serum IL-28A and HMGB1 in active group were significantly decreased after treatment,and the difference was statistically significant(t=16.483,P<0.001&t=10.682,P=0.001).Conclusion:Serum IL-28A and HMGB1 are highly expressed in AS,which are positively correlated with disease activity,and have certain value in diagnosis and therapeutic effect evaluation of AS.