巨噬细胞相关细胞因子在红斑狼疮患者血清中的表达及意义

摘要

目的：研究巨噬细胞相关的细胞因子在不同类型红斑狼疮患者外周血中的表达及其意义。方法采用ELISA测定15例盘状红斑狼疮（ DLE）、34例亚急性皮肤型红斑狼疮（ SCLE）、47例系统性红斑狼疮患者（ SLE）及17例正常对照者血清中IL-18、MIF、MIP1-α水平，比较四组间的差异并分析与临床的相关性。结果3种类型的红斑狼疮患者血清中IL-18、MIF、MIP1-α的表达水平均与正常相比差异显著（P＜0.001），且不同类型间存在显著差异（P＜0.05）；SLE患者尿蛋白≥500mg／24hr、疾病活动度评分≥8分，ANA滴度≥1：320以及激素治疗前后血清中IL-18水平显著升高（ P＜0.05），且与SLE患者激素治疗剂量及呈显著负相关（ r＝-0.465，P＝0.002）。结论巨噬细胞相关细胞因子参与红斑狼疮炎症形成过程，其中IL-18可反映SLE病情轻重及对激素治疗的反应。%Objective To investigate the serum levels of macrophage related cytokines in patients with lupus of different types and their clinical significance.Methods The serum levels of IL-18, MIF and MIP1 -a were detected in 15 patients with DLE, 34 patients with SCLE, 47 patients with SLE and 17 normal controls by ELISA.The differ-ence in various groups and its correlations with clinic features were analyzed.Results Serum levels of IL-18, MIF and MIP1 -a were significantly higher in patients with lupus of different types than that of normal controls ( P<0. 001) , and there are significantly differences between each other ( P<0.05) .Moreover, serum levels of IL-18 in pa-tients with SLE who with high levels of serum complement3, SLEDAI,24-hour proteinuria or ant-ds-DNA antibodie were significantly higher than that of lower level patients( P<0.05) , in addition,there was a significant negative cor-relation between IL-18 and the dose of corticosteroids therapy ( r=-0.465,P=0.002) .Conclusion Macrophage in-flammatory cytokines involved in the inflammatory pathomechanism of lupus, IL-18 can reflect disease activity and the response to corticosteroids treatment of patients with SL.