吴昭元+唐毓金+卓航宇+贺玉棚+廖林波+农峰+卢贤哲

【摘要】目的檢测广西地区骨与关节结核患者外周血中白细胞介素23（IL23）的表达水平并探讨其临床意义。

方法收集2015年7月～2016年7月收治的45例骨与关节结核患者作为观察组， 选择同期在体检中心进行健康体检的54名健康者作为对照组。采用免疫酶联吸附法（ELISA）检测两组外周血血清IL23的表达水平，同时采用常规方法对C反应蛋白（CRP）和红细胞沉降率（ESR）进行检测，比较两组间IL23、CRP及ESR表达水平的差异，分析观察组IL23水平与CRP、ESR水平之间的相关性。

结果两组受试者外周血IL23、CRP及ESR表达含量差异有统计学意义（P<0.001）。观察组IL23、CRP及ESR水平均显著高于对照组；观察组外周血IL23与CRP、ESR水平均无线性相关（P>0.05）。

结论广西地区骨与关节结核患者外周血中IL23的表达水平明显升高，提示其可能在骨与关节结核发病中起重要作用。

【关键词】骨与关节结核；白细胞介素23；C反应蛋白；红细胞沉降率

中图分类号：R529.2文献标识码：ADOI：10.3969/j.issn.10031383.2017.02.004

【Abstract】ObjectiveTo detect the expression of interleukin23（IL23） level in peripheral blood of patients with bone and joint tuberculosis in Guangxi and to explore its clinical significance.

MethodsFortyfive patients with bone and joint tuberculosis admitted to our hospital from July，2015 to July，2016 were selected as observation group.And fiftyfour healthy subjects were selected as control group.The levels of serum IL23 in peripheral blood were measured by enzymelinked immunosorbent assay（ELISA） in both groups and the levels of plasma C reactive protein（CRP） and erythrocyte sedimentation rate（ESR） were tested by routine method.The difference of levels of IL23，CRP and ESR was compared between the two groups and correlation between IL23 levels and CRP，ESR levels in the observation group was analyzed.

ResultsDifference of expression levels of IL23，CRP and ESR in peripheral blood of both groups was statistically significant（P<0.001）.The levels of IL23，CRP and ESR in the observation group were significantly higher than those in the control group，and there was no linear correlation between IL23 and CRP and ESR in the peripheral blood of the observation group（P>0.05）.

ConclusionThe expression of IL23 in peripheral blood of patients with bone and joint tuberculosis in Guangxi significantly increases，which suggests that IL23 may play an important role in the pathogenesis of bone and joint tuberculosis.

【Key words】bone and joint tuberculosis；IL23；CRP；ESR

骨与关节结核（bone and joint tuberculosis，BJTB）是由结核分枝杆菌侵入骨或关节而引起的化脓性破坏性病变，是常见的肺外结核，好发于脊柱，如果治疗不及时，后期容易出现窦道、畸形甚至截瘫[1]。近年来，由于耐药性（占结核病患者11%）的增加、合并HIV感染、人口流动性的增加等使我国BJTB的发病率并没有明显下降[2～3]。BJTB发病较为隐匿，早期无典型的临床症状，预防及早期诊断尤为重要。白细胞介素23（interleukin23，IL23）是由p19亚基和p40亚基通过二硫键连接产生的一种异源二聚体细胞因子，属于IL12家族成员，由树突状细胞和巨噬细胞等产生参与免疫和炎症反应[4]。……