血清IL-17和IL-23水平在类风湿关节炎患者中的变化及其临床意义

目的探讨类风湿关节炎(RA)患者血清白细胞介素(IL)17、IL-23的变化及其临床意义。方法选取2010年9月至2012年8月在内江第一人民医院风湿免疫科住院治疗的RA患者123例作为观察组,选择同期60例健康体检者作为对照组,检测两组受试者的血清IL-17及IL-23水平并进行对比分析,同时分析RA患者血清IL-17及IL-23与病情的关系、治疗前后变化及与其他临床指标的关系。结果观察组IL-17、IL-23水平均显著高于对照组(P<0.01);RA患者血清IL-17、IL-23水平随着病情活动的加重而显著增高(P<0.01);治疗组患者IL-17、IL-23水平显著低于未治疗组(P<0.01);IL-17与疼痛视觉模糊评分(VAS)、生活质量评分(HAQ)、关节压痛数(TJC)、关节肿胀数(SJC)、红细胞沉降率(ESR)、类风湿因子(RF)及骨质破坏(Sharp)评分均呈显著正相关(P<0.05或P<0.01);IL-23与晨僵时间、VAS、HAQ、TJC、SJC、ESR、血小板计数、抗环瓜氨酸抗体、RF及Sharp评分呈显著正相关(P<0.05或P<0.01)。结论血清IL-17、IL-23水平可在一定程度上反映RA病情,对疾病的治疗效果评估也具有重要作用。

The Changes and Clinical Significance of Serum IL-17 and IL-23 in Patients with Rheumatoid Arthritis

Objective To discuss the changes and clinical significance of serum interleukin（IL） 17 and IL-23 in patients with rheumatoid arthritis （RA）. Methods Serum IL-17 and interleukin-23 （ 1L-23 ） were detected and contrasted in 123 patients with RA（ the observation group） hospitalized in Department of Rheumatology, Neijiang City First People＇s Hospital and 60 healthy people （ the control group） during Sep. 2010 and Aug. 2012 ,and the relationship of serum IL-17 ,IL-23 with RA, changes with treatment and relationship with other clinical indicators were analyzed. Results Serum IL-17 and IL-23 in the observation group were significantly higher than the control group （ P 〈 0. 01 ） ; serum IL-17 and IL-23 level was significantly elevated with the aggravation of disease（ P 〈 0. 01 ） ;serum IL-17, IL-23 in observation group was significantly lower than untreated group（ P 〈 0. 01 ） ;serum IL-17 had a significant positive correlation with visual analogy scale （VAS） , health assessment questionnaire （ HAQ ）, tender joint count （ TJC ） , swollen joints count （ SJC ） , erythrocyte sedimentation rate （ESR） , RF and Sharp score （ P 〈 0.05 or P 〈 0.01 ） ; IL-23 had a significant positive correlation with the duration of morning stiffness, VAS, HAQ, TJC, SJC, ESR, platelet count, Anticyclic eitrullinated peptide antibodies, RF and Sharp score （ P 〈 0.05 or P 〈 0.01 ）. Conclusion Serum IL-17 and IL-23 levels have important significance in the disease condition judgment and efficacy assessment in patients with RA.