血清白细胞介素6水平测定在多发性肌炎患者病情评估中的价值

目的 检测多发性肌炎(polymyositis,PM)患者血清中炎症因子白细胞介素6(IL-6)的水平,分析IL-6与PM患者临床及实验室相关指标、糖皮质激素(GC)治疗的关系,探讨炎症因子IL-6等在PM发病机制及治疗中的作用。 方法 选择2010年4月—2014年1月在浙江省人民医院采用酶联免疫吸附法(ELISA)检测36例PM患者血清中IL-6以及TNF-α水平,并与同期10例健康体检者对照(健康对照组)。利用国际肌炎组织制定的炎性肌病评价工具,将患者分为活动期与缓解期2组。3组间计量资料比较采用方差分析,2组间计量资料比较采用t检验,组间计量资料相关性采用Spearman法。 结果 血清IL-6在多发性肌炎活动组[(19.67±7.16) pg/ml]、缓解组[(15.81±4.00) pg/ml]中的水平均显著高于健康对照组[(8.14±3.71) pg/ml,P<0.001],且活动组显著高于缓解组(P=0.043)。TNF-α在活动组[(114.44±36.04) pg/ml]、缓解组[(97.65±30.78) pg/ml]中的水平显著性高于健康对照组[(55.43±22.83) pg/ml,P<0.001],但活动组与缓解组比较差异无统计学意义(P=0.141)。分析发现血清IL-6水平与TNF-α水平呈显著正相关(r=0.709,P<0.001),与GC治疗量呈负相关(r=-0.573,P<0.001)。 结论 IL-6可作为PM疾病活动评估及治疗中激素量的重要参考指标。 

Serum IL-6 as the important biomarker in disease evaluation of polymyositis

Objective To detect the serum concentrations of interleukin-6 (IL-6) in patients with polymyositis (PM), and to explore its clinical relationships in order to investigate the pathogenesis and treatment of PM. Methods Thirty-six patients with polymyositis were enrolled from April, 2010 to January, 2014 in our study. Serum IL-6 and TNF-α were detected using a commercially available EILSA. The statistical differences between groups were evaluated by the analysis of variance (ANOVA). The Spearman's correlation test was used to evaluate the relationship of IL-6 and clinical and laboratory data. Results Serum IL-6 concentrations were (19. 67 ±7. 16) pg/ml in active PM patients, and (15. 81 ±4. 00) pg/ml in remission, which were significantly higher than those of controls[(8. 14 ±3. 71) pg/ml, P < 0. 001]. Furthermore, IL-6 concentrations in active PM patients were significantly higher than those in remission (P=0. 043). TNF-αconcentrations were (114. 44 ±36. 04) pg/ml in active PM patients, and (97. 65 ±30. 78) pg/ml in remission, which were significantly higher than those of controls[(55. 43 ±22. 83) pg/ml, P < 0. 001]. However, there was no significant deference between PM patients in active phase and in remission. The serum IL-6 levels were positively correlated TNF-α (r=0. 709, P=0. 000), and negatively correlated with current glucocorticoid dose (r=-0. 573, P=0. 000). Conclusion IL-6 could be used as a marker of hormone dosage when evaluating and treating PM disease.