孙薇

[關键词] IL-1α;IL-1Ra水平;多发性硬化病;预后转归

[中图分类号] R744.51          [文献标识码] B          [文章编号] 1673-9701（2021）14-0045-04

Study on the correlation between interleukin-1α and interleukin-1 receptor antagonist and multiple sclerosis

SUN Wei

Department of Neurology， the Second Hospital of Chaoyang City in Liaoning Province， Chaoyang   122000， China

[Abstract] Objective To explore the correlation between the levels of interleukin-1α（IL-1α） and interleukin-1 receptor antagonist （IL-1Ra） and multiple sclerosis. Methods A total of 130 patients with multiple sclerosis admitted to our hospital from February 2018 to June 2020 were selected as the case group， and 130 healthy volunteers who received physical examination during the same period were selected as the control group. The levels of IL-1α and IL-1Ra in peripheral blood and cerebrospinal fluid of the two groups were detected. At the same time，peripheral blood and cerebrospinal fluid of the case group were collected to detect the levels of IL-1α and IL-1Ra before treatment， at 7 days， 14 days，and 28 days after treatment. The levels of IL-1α and IL-1Ra in peripheral blood and cerebrospinal fluid were compared before and 28 days after treatment between the good prognosis group and the poor prognosis group of the case group， and compared with the control group. Results The levels of IL-1α in peripheral blood and cerebrospinal fluid in the case group were higher than those in the control group， and the IL-1Ra levels in the case group were lower than those in the control group（P<0.05）. After 7 d， 14 d， and 28 d of treatment， the levels of IL-1α in peripheral blood and cerebrospinal fluid in the case group gradually decreased， and IL-1Ra levels gradually increased（P<0.05）. Twenty-eight days after treatment， the patients were divided into the good prognosis group and the poor prognosis group according to the treatment effect of the case group. There was no statistically significant difference in indicators between the two groups before treatment （P>0.05）. After 28 days of treatment， the indicators of the good prognosis group were not significantly different from the control group， without significant difference（P>0.05）. The levels of IL-1α in peripheral blood and cerebrospinal fluid in the poor prognosis group were higher than those in the control group， and IL-1Ra level in the poor prognosis group was lower than that in the control group，with significant difference（P<0.05）. Conclusion There is a significant correlation between interleukin-1α and leukocyte-1 receptor antagonist and multiple sclerosis. The abnormal expression of IL-1α and IL-1Ra in peripheral blood and cerebrospinal fluid may be closely related to the onset and outcome of MS，and can be used as an important indicator to judge the severity of the disease and the treatment effect.

[Key words] IL-1α; IL-1Ra level; Multiple sclerosis; Prognostic outcome

多发性硬化病（Multiple sclerosis，MS）是由T细胞介导的，以神经系统的慢性炎症性脱髓鞘为主要特征的一种自身免疫性疾病[1-2]，其主要特征是大脑、脊髓中的脱髓鞘斑块在时间、空间上的扩散，从而导致运动、感觉、视觉、认知等方面的功能障碍[3]。目前医学界对于多发性硬化病的病因病机认知还不清楚，但不少研究指出，先天免疫调节功能紊乱、后天环境所致的异常自身免疫应答可能诱发该病的主要原因[4]。由于该病的自身免疫性，因而研究多集中在T细胞和B细胞上，但近年来不少学者发现，多种炎症介质参与到MS的发病中，尤其是白细胞介素-1家族[5]。白细胞介素-1（Interleukin-1，IL-1）是一种前炎症细胞因子，在免疫炎症反应中起到重要作用，一般是通过修饰基因起作用。在急性免疫反应中，IL-1的表达被严格调控，但在一些自体免疫性疾病中，IL-1会逃离这种调控，并慢性表达。IL-1α（Interleukin-1α）、IL-1Ra（Interleukin-1Ra）是主要的IL-1家族成员，临床研究发现，在MS病灶中检出IL-1α、IL-1β（Interleukin-1β），在恶化过程中血浆IL-1Ra水平升高。且IL-1α、可溶性IL-1受体对MS疾病严重程度有一定影响，提示IL-1家族参与到MS的病理生理过程中。为此，本研究特分析MS患者脑脊液和外周血中的IL-1α、IL-1Ra水平，探索其与多发性硬化症之间的相关性，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年2月至2020年6月期间我院诊治的多发性硬化病患者130例为病例组，并选取同期体检的健康志愿者130例为对照组，其中病例组患者均为急性发病期MS，无其他自身免疫性疾病、呼吸道感染、脑膜炎、恶性肿瘤等疾病，近1个月内无免疫抑制剂、激素、抗生素等药物治疗史。同……