自发性荨麻疹患者外周血中白细胞介素-1β、白细胞介素-1受体拮抗剂和单核细胞计数的变化及意义

Changes of IL-1β,IL-1Ra,and monocyte count in spontaneous urticaria patients and their clinical significances

目的:探讨自发性荨麻疹患者外周血中白细胞介素(IL)-1β、IL-1受体拮抗剂(IL-1Ra)及单核细胞计数的变化及意义。方法:收集急性自发性荨麻疹患者106例(组1),包括显效者81例(组1a)和迁延者25例(组1b),同时收集慢性自发性荨麻疹患者75例(组2),包括发作期患者33例(组2a)和缓解期患者42例(组2b)。采集患者的一般信息、IL-1β和IL-1Ra水平、单核细胞和淋巴细胞计数进行统计分析,并与42例健康对照者(组3)相比较。结果:三组IL-1β和IL-1Ra表达分别依次递减:组1 [(2.84±1.86)ng/L,(350.87±217.99)ng/L]、组2 [(1.81±1.30)ng/L,(180.29±113.34)ng/L]和组3 [(1.21±0.99)ng/L,(116.52±57.18)ng/L],且各组间比较差异均有统计学意义(P<0.05)。进一步比较IL-1β显示,组1a[(2.86±1.81)ng/L]和组1b[(2.77±2.06)ng/L]比较差异无统计学意义(P>0.05);组2a[(2.16±1.54)ng/L]高于组2b[(1.54±1.00)ng/L],差异有统计学意义(P<0.05)。比较IL-1Ra显示,组1a[(376.82±230.27)ng/L]高于组1b[(266.81±146.71)ng/L],差异有统计学意义(P<0.05);组2a[(185.21±91.17)ng/L]和组2b[(176.43±129.08)ng/L]比较,差异无统计学意义(P>0.05)。比较单核细胞计数显示,组1a[(0.42±0.17)×10^(9)/L]高于组3[(0.35±0.11)×10^(9)/L],差异有统计学意义(P<0.05)。各组间淋巴细胞计数比较,差异无统计学意义(P>0.05)。结论:IL-1β和IL-1Ra在自发性荨麻疹发病和转归中可能发挥重要的作用。急性自发性荨麻疹患者外周血中高水平的IL-1Ra和单核细胞计数可能提示预后较好,慢性自发性荨麻疹患者外周血中IL-1β的高表达可能与病情活动度相关。

Objective: To investigate the levels of IL-1β, IL-1 receptor antagonist(IL-1Ra) and monocyte count in patients of spontaneous urticaria and the clinical significance. Methods: Enrolled were 106 acute spontaneous urticaria patients(group 1),including 81 with significant effect(group 1a) and 25 with delayed effect(group 1b), and 75 chronic spontaneous urticaria patients(group 2), including 33 in attack stage(group 2a) and 42 in remission stage(group 2b), whose general information, IL-1β and IL-1Ra levels, monocyte and lymphocyte counts were collected for statistical analysis, and then compared with 42 healthy controls(group 3). Results: The IL-1β and IL-1Ra levels in the descending order were group 1[(2.84±1.86)ng/L,(350.87±217.99)ng/L],group 2[(1.81±1.30)ng/L,(180.29±113.34)ng/L] and group 3[(1.21±0.99)ng/L,(116.52±57.18)ng/L], and there were significant differences among the groups(all P<0.05). Further comparison of IL-1β showed that the difference between group 1a[(2.86±1.81)ng/L]and group 1b[(2.77±2.06)ng/L] was not statistically significant(P>0.05), but group 2a[(2.16±1.54)ng/L] was higher than group 2b[(1.54±1.00)ng/L](P<0.05). Comparison of IL-1Ra showed that group 1a[(376.82±230.27)ng/L] was higher than group 1b[(266.81±146.71)ng/L](P<0.05), but the difference between group 2a[(185.21±91.17)ng/L] and group 2b[(176.43±129.08)ng/L] was not statistically significant(P>0.05). Comparison of monocyte count showed that group 1a[(0.42±0.17)×10^(9)/L] was higher than group 3[(0.35±0.11)×10^(9)/L](P<0.05). There was no significant difference in lymphocyte count among the groups(P>0.05). Conclusions:IL-1β and IL-1Ra may play important roles in the pathogenesis and prognosis of spontaneous urticaria. High levels of IL-1Ra and monocyte count in the peripheral blood of acute spontaneous urticaria may predict a better prognosis. Higher expression of IL-1β in the peripheral blood of chronic spontaneous urticaria may be positively correlated with the activity of the disease.