吴太锋+农峰+陈松强+戚海+黄海超+罗春林+卢贤哲

【摘要】目的通过检测广西骨关节结核患者血清中白细胞介素4（IL4）和白细胞介素17（IL17）的表达水平，以探讨其临床意义。方法选择在2016年2～6月期间住院治疗的43例广西骨关节结核患者作为观察组，同期选择56名健康者作为对照组，应用酶联免疫吸附法（ELISA）检测两组受试者外周血血清IL4和IL17的表达情况，并比较两组间的差异，分析观察组血清IL4和IL17水平的线性关系。结果观察组血清IL4和IL17的表达水平均明显高于对照组[分别为（54.10±6.77）pg/ml vs （19.06±3.29） pg/ml和（58.63±7.88）pg/ml vs（20.57±4.24）pg/ml]，差异有统计学意义（P<0.01）；观察组血清IL4与IL17的表达含量呈明显正相关（P<0.001）。结论广西骨关节结核患者血清IL4和IL17的表达水平升高，提示其可能参与骨关节结核的发病机制。

【关键词】骨关节结核；白细胞介素4；白细胞介素17

中图分类号：R529.2文献标识码：ADOI：10.3969/j.issn.10031383.2016.05.016

【Abstract】ObjectiveTo detect the serum levels of interleukin4（IL4） and interleukin17（IL17） in patients with bone and joint tuberculosis in Guangxi，so as to explore its clinical significance.Methods43 cases of bone and joint tuberculosis in Guangxi who were treated in the hospital from February，2016 to June，2016 were selected as experimental group and 56 healthy subjects during the same period were chosen as control group.The serum levels of IL4 and IL17 were measured by enzyme linked immunosorbent assay（ELISA）.Difference of IL4 and IL17 levels was compared between the two groups，and the linear correlation of IL4 and IL17 levels was observed and analyzed in the experimental group.ResultsThe serum levels of IL4 and IL17 in the experimental group and the control group were （54.10±6.77） pg/ml vs （19.06±3.29） pg/ml and （58.63±7.88） pg/ml vs （20.57±4.24）pg/ml respectively，those of the experimental group were significantly higher than those of the control group，difference was statistically significant（P<0.01）.There was obviously positive linear correlation between serum IL4 and IL17 levels in the experimental group（P<0.001）.ConclusionThe expression of serum IL4 and IL17 levels in patients with bone and joint tuberculosis in Guangxi significantly increase，suggesting that they may involve in the pathogenesis of bone and joint tuberculosis.

【Key words】bone and joint tuberculosis；IL4； IL17

骨關节结核（bone and joint tuberculosis）是一种由结核分枝杆菌引起的感染性骨科疾病。由于骨关节结核可导致关节疼痛、畸形及功能活动障碍，甚至出现截瘫[1]，给患者带来极大的痛苦，严重影响患者的生活质量，同时造成巨大的社会经济负担，其已成为骨科医生亟待解决的难题。目前，骨关节结核的发病机制尚未阐明。白细胞介素4（interleukin4，IL4）是一种主要由活化T细胞产生的促炎症性因子。研究证实[2]，IL4在机体内参与肺结核的免疫调节，在肺结核的发病中起关键作用。白细胞介素17（interleukin17，IL17）是一种主要由CD4+淋巴细胞亚群TH17细胞分泌的促炎症性细胞因子。近年来，IL17参与肺结核起病的相关研究已逐渐得到证实[3]。然而，目前国内外关于IL4和IL17在骨关节结核的研究报道较鲜见。本实验采用双抗体夹心酶联免疫吸附法（ELISA）检测43例广西骨关节结核患者及56名健康者血清IL4和IL17的表达情况，同时分析骨关节结核患者血清中IL4和IL17表达水平的线性关系，以初步探讨两种细胞因子是否参与骨关节结核的免疫调节。……