黄钊炜 黄芳琴 任妮娜

【摘 要】目的：研究强直性脊柱炎患者疾病活动度与细胞因子的相关性。方法：选取2020年9月至2021年3月在贵州中医药大学第二附属医院风湿科住院诊治的强直性脊柱炎患者180例，记录其年龄、身高、体质量和强直性脊柱炎病情活动度评分（ASDAS）的相关指标，采用流式免疫荧光法检测多种细胞因子[白细胞介素（IL）-2、IL-6、IL-10、γ干扰素（IFN-γ）和肿瘤坏死因子-α（TNF-α）]水平，并进行相关性分析。结果：与低疾病活动度患者相比，活动度高的患者IL-6和IFN-γ水平更高，差异有统计学意义（P < 0.05）。Spearman相关分析显示，ASDAS与IL-6（r = 0.693）、IL-10（r = 0.154）和IFN-γ（r = 0.153）呈正相关（P < 0.05）。二元Logistic回归分析结果显示，IL-6（OR = 1.085，95%CI =[1.043，1.128]，P < 0.05）是强直性脊柱炎患者疾病活动度升高的独立危险因素。结论：强直性脊柱炎疾病活动度与IL-6和IFN-γ升高相关，可作为初步评估疾病活动度的参考指标。IL-10可能与AS疾病活动存在相关性，需要更多研究证实。

【关键词】 强直性脊柱炎;细胞因子;疾病活动度;流式免疫荧光法

【ABSTRACT】Objective：To study the correlation between disease activity and cytokines in patients with ankylosing spondylitis.Methods：One hundred and eighty patients with ankylosing spondylitis hospitalized in the Rheumatology Department of the Second Affiliated Hospital of Guizhou University of Chinese Medicine from September 2020 to March 2021 were selected.Their age，height，body mass and related indexes of ASDAS were recorded.The levels of a variety of cytokines（IL-2，IL-6，IL-10，IL-10，IFN-γ and TNF-α）were detected with flow immunofluorescence and correlation analysis was carried out.Results：Compared with patients with low disease activity，patients with high disease activity had higher levels of IL-6 and IFN-γ，and the difference was statistically significant.Spearman correlation analysis showed that ASDAS was positively associated with IL-6（r = 0.693），IL-10（r = 0.154）and IFN-γ（r = 0.153）（P < 0.05）.Binary logistic regression analysis showed that IL-6（OR = 1.085，95%CI = [1.043，1.128]）was an independent risk factor for increased disease activity in patients with ankylosing spondylitis（P < 0.05）.Conclusion：Disease activity of ankylosing spondylitis was related to the increase of IL-6 and IFN-γ，which can be used as a reference index for preliminary evaluation of disease activity.IL-10 may be related to the disease activity of ankylosing spondylitis，which needs to be confirmed by more studies.

【Keywords】 ankylosing spondylitis;cytokines;disease activity;flow immunofl-uorescence

強直性脊柱炎（ankylosing spondylitis，AS）主要影响脊柱和骶髂关节，是脊柱关节炎最常见的亚型。我国AS的患病率约为0.32%，多发于15～40岁，男性好发[1]。本病发病原因不明，易反复发作，造成椎间盘纤维化及其附近韧带钙化和骨性强直，严重影响患者的生活和工作。特别是在疾病活动期，由于关节融合加上炎症作用会导致明显的疼痛、僵硬及关节活动受限。最近的研究表明，AS发病与多种炎症细胞因子异常分泌相关，各种细胞因子在AS发展过程中扮演着重要角色[2-3]。因此，本研究采用最新的多重微球流式免疫荧光发光法检测AS患者的多项细胞因子水平，探讨AS患者疾病活动度与炎症细胞因子的相关性，为AS的诊治和研究提供新方向。

1 资料与方法

1.1 一般资料 选取2020年9月至2021年3月在贵州中医药大学第二附属医院风湿科住院诊治的AS患者180例。所有患者诊断均符合1984年美国风湿病学会（ACR）修定的AS纽约标准。……