湿热型强直性脊柱炎患者氧化应激相关指标的变化及相关性研究

Changes and correlation analysis of oxidative stress in ankylosing spondylitis patients with damp-heat syndrome

目的:观察湿热型强直性脊柱炎(AS)患者血清氧化应激相关指标的变化,并进行相关性研究。方法:将30例湿热型A S患者及30例健康对照者分别列为A S组和正常组,用E L I SA法检测两组血清中丙二醛(MDA)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)、白细胞介素-4(IL-4)、IL-10、IL-1β,肿瘤坏死因子-α(TNF-α)水平。仪器法测定血沉(ESR),全自动生化分析仪检测超敏C反应蛋白(hs-CRP),问卷量表观察AS患者疼痛视觉模拟评分(VAS评分)、Bath强直性脊柱炎疾病活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、Bath强直性脊柱炎计量学指数(BASMI)、Bath强直性脊柱炎总体指数(BAS-G),并分析氧化应激相关指标及细胞因子与AS患者疾病活动相关指标之间的相关性。结果:①与正常组比较,AS组MDA、LPO、IL-1β、TNF-α显著升高(P<0.01),TAOC、SOD、IL-4、IL-10显著降低(P<0.01)。②AS组IL-1β与ESR、hs-CRP、VAS评分呈正相关(P<0.01),TNF-α与ESR、hs-CRP、BASDAI、BAS-G、VAS评分呈正相关(P<0.01,P<0.05),IL-4与ESR、hs-CRP、BASDAI、VAS评分呈负相关(P<0.01,P<0.05),IL-10与ESR、hs-CRP、BASMI、VAS评分呈负相关(P<0.05,P<0.01)。③SOD与TNF-α、VAS评分呈负相关(P<0.05),与IL-4呈正相关(P<0.01),TAOC与TNF-α、ESR、hs-CRP、BASDAI、BASFI、BAS-G、VAS评分呈负相关(P<0.01,P<0.05),LPO与TNF-α、IL-1β、BASMI评分呈正相关(P<0.05),与IL-10呈负相关(P<0.01),MDA与TNF-α、IL-1β、ESR、hs-CRP、BASDAI、VAS评分呈正相关(P<0.01,P<0.05),与IL-4、1L-10呈负相关(P<0.05)。结论:AS患者存在氧化应激损伤、细胞因子紊乱,且与疾病活动相关指标存在一定相关性。

Objective:To detect the expression of oxidative stress in serum of ankylosing spondylitis(AS)patients with damp-heat syndrome,and analyze their correlation with the disease.Methods:Thirty cases of damp-heat type ankylosing spondylitis and 30 cases healthy people were divided into AS group and normal group,enzyme linked immunosorbent assay(ELISA)were employed to measure the expression levels of malondialdehyde(MDA),lipid peroxidation(LPO),total antioxidant capacity(TAOC),superoxide dismutase(SOD),and interleukin(IL)1β,IL-4,IL-10,tumor necrosis factor(TNF-α)in serum from 30 patients and 30 healthy people.Erythrocyte sedimentation rate(ESR)was detected by instrument method.C-reactive protein were detected by automatic biochemical analyzer.Observe the visual analog scales(VAS),Bath ankylosing spondylitis diseases active index(BASDAI),Bath ankylosing spondylitis functional index(BASFI),Bath ankylosing spondylitis metrological index(BASMI),Bath ankylosing spondylitis global index(BAS-G)of AS patients by the questionnaire scale.We observed the differences of the above indicators between the two groups and analyzed the correlation between oxidative stress and cytokine and disease activity indicators in AS patients.Results:①The level of MDA,LPO,IL-1βand TNF-αwere significantly increased(P<0.01),TAOC,SOD,IL-4 and IL-10 were significantly decreased compared with normal control group(P<0.01).②The correlation analysis showed that IL-1βwas positively correlated with ESR,hs-CRP,VAS(P<0.01).TNF-αwas positively correlated with ESR,hs-CRP,BASDAI,BAS-G,VAS(P<0.05,P<0.01).IL-4 was negatively correlated with ESR,hs-CRP,BASDAI,VAS(P<0.05,P<0.01).IL-10 was negatively correlated with ESR,hs-CRP,BASMI and VAS(P<0.05,P<0.01).③The correlation analysis showed that SOD was negatively correlated with TNF-α,VAS(P<0.05),positively correlated with IL-4(P<0.01).TAOC was negatively correlated with TNF-α,ESR,hs-CRP,BASDAI,BASFI,BAS-G,VAS(P<0.05,P<0.01).LPO was positively correlated with TNF-α,IL-1β,BASMI(P<0.05),negatively correlated with IL-10(P<0.01).MDA was positively correlated with TNF-α,IL-1β,ESR,hs-CRP,BASDAI,VAS(P<0.01,P<0.05),negatively correlated with IL-4,1L-10(P<0.05).Conclusion:There exists oxidative stress injury and disorders of cytokines in AS patients,and these indexes have certain relevance with the disease.