痛风患者外周血中炎症因子IL-18、IL-1β、TNF-α的变化

目的 了解痛风患者外周血中炎症因子IL-18、IL-1β、TNF-α的变化,探讨其在痛风发病中的作用。 方法 病例选自2013年8月—2014年10月浙江中医药大学附属第二医院门诊及病房就诊患者,痛风组共49例(急性期24例、间歇期25例),正常对照组为同期门诊健康体检人群,共16例。均抽空腹外周静脉血,检测血尿酸、C反应蛋白(CRP)、白细胞介素-1β(interleukin-1 beta,IL-1β)、白细胞介素-18(interleukin-18,IL-18)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)。 结果 痛风组与正常对照组血清IL-18分别是105.66(43.32,190.83)]pg/ml、0.00(0.00,0.00)]pg/ml,IL-1β分别是0.00(0.00,0.15)]pg/ml、0.03(0.00,0.30)]pg/ml,TNF-α分别是0.00(0.00,4.60)]pg/ml、0.00(0.00,6.77)]pg/ml,2组相比IL-18差异有统计学意义(P<0.001),IL-1β与TNF-α差异无统计学意义(P>0.05)。痛风患者血尿酸与炎症因子关联性分析结果表明:尿酸与IL-18呈正相关(r_s=0.497,P<0.001);CRP与IL-18呈正相关(r_s=0.366,P=0.010);血清中IL-18、IL-1β、TNF-α的变化无相关性(P>0.05)。急性期尿酸与TNF-α呈负相关(r=-0.431,P=0.036);间歇期,IL-18与IL-1β呈负相关(r_s=-0.402,P=0.046),尿酸与炎症因子不相关,尿酸与CRP不相关。 结论 痛风患者外周血中IL-18显著增高,IL-18可能参与痛风的慢性炎症过程,并与尿酸的升高相关。 

Changes of inflammatory cytokines IL-18,IL-1 beta and TNF alpha in peripheral blood of patients with gout

Objective To investigate the changes of inflammatory cytokines IL-18, IL-1 beta and TNF alpha in peripheral blood in patients with gout, and explore its role in gout and high uric acid hematic disease. Methods A total 49 cases were recruited from outpatients in our hospital and ward patients between August, 2013 and October, 2014 (includes 24 cases in acute phase and 25 cases in intermission). 9 cases in normal control group came from health check-up crowd in the same period in outpatients. The fast peripheral venous blood was prepared, and the levels of blood uric acid, C-reactive protein (CRP), interleukin 1 beta (interleukin 1 beta, IL-1 beta), interleukin-18 (interleukin-18, IL-18) and tumor necrosis factor alpha (Tumor necrosis factor-alpha, TNF-α) were tested. Results The serum level of IL-18 in Gout group and the normal control group were105. 66 (43. 32, 190. 83)]pg/ml and0. 00 (0. 00, 0. 00)]pg/ml, respectively; levels of IL-1 beta were0. 00 (0. 00, 0. 15)]pg/ml and0. 03 (0. 00, 0. 30)]pg/ml, levels of TNF-α were0. 00 (0. 00, 4. 60)]pg/ml and0. 00 (0. 00, 6. 77)]pg/ml. When compared with normal control group, the difference in IL-18 was statistically significant (r_s=0. 497, P < 0. 001). CRP and IL-18 were positively correlated (r_s=0. 366, P=0. 010); There was no correlation between the changes of IL-18, IL-1 and TNF-α. But Uric acid and TNF-α were negative correlated (r=-0. 431, P=0. 036) in acute stage. In intermission, IL-18 and IL-1β were negative correlated (r_s=-0. 402, P=0. 046), There was no correlation IL-18, IL-1, TNF-α, CRP with Uric acid. Conclusion The level of IL-18 in the peripheral blood raise significantly in gout patients. IL-18 may participate in the process of chronic inflammatory in gout and relate to the increase of uric acid.