目的 探讨强直性脊柱炎(AS)患者血清瘦素(LP)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、白细胞介素-23(IL-23)的临床意义.方法 选取AS患者40例(观察组) ,根据Bath AS 活动指数(BASDAI)评分将患者分为BASDAI≤4分组(稳定期组) ,BASDAI＞4分组(活动期组) ;根据不同骶髂关节CT 分级将患者分为Ⅰ级组、Ⅱ级组、≥ Ⅲ级组;根据HLA-B27结果将患者分为HLA-B27阳性组、HLA-B27阴性组;另选取同期体检的健康者40例作为对照组.检测各组研究对象外周血中LP、IL-6、IL-17、IL-23水平,以及红细胞沉降率(ESR)、C反应蛋白(CRP)水平,并进一步分析各组血清LP、IL-6、IL-17、IL-23与AS疾病活动性BASDAI、血清免疫学指标的相关性.结果 观察组血清LP、IL-6、IL-17、IL-23水平高于对照组,差异均有统计学意义(P＜0 .05) ,活动期LP、IL-6、IL-17、IL-23水平与稳定期比较亦增高(P＜0 .05) ;骶髂关节CT Ⅰ、Ⅱ级组患者血清L P、IL-6、IL-17、IL-23水平高于对照组(P＜ 0 .05) ,≥ Ⅲ级组患者与对照组相比差异无统计学意义(P＞0 .05) ,Ⅰ、Ⅱ级组患者与≥ Ⅲ级组患者比较差异有统计学意义(P＜0 .05) ;HLA-B27阳性组与阴性组比较血清LP、IL-6、IL-17、IL-23差异无统计学意义(P＞0 .05) ;AS患者血清LP、IL-6、IL-17、IL-23与ESR、CRP、BAS-DAI间各自为正相关关系.结论 AS患者外周血中LP、IL-6、IL-17、IL-23水平显著上升,且与疾病活动性呈正相关.%Objective To investigate the clinical significance of leptin ,LP ,IL-6 ,IL-17 and IL-23 in patients with ankylosing spondylitis (AS).Methods Forty patients with AS were selected and divided into different groups with 3 different ways .They were divided into Bath AS disease activity index (BASDAI)≤4 scores (stable) group and BASDAI ＞ 4 scores (active) group ;They were divided into 4 groups-Ⅰ,Ⅱ,≥ Ⅲ with the CT result of sacroiliac joint .They were divided into positive and negative group with HLA-B27 .Another forty healthy persons were included as control group .And then test the serum levels of LP ,IL-6 ,IL-17 ,IL-23 and ESR ,CRP in all the subjects ,and the values were tested and compared between different groups .In addition , the relationship between various parameters ,serum immune index and those with BASDAI were further ana-lyzed .Results The serum levels of LP ,IL-6 ,IL-17 ,IL-23 of observation group patients were higher than nor-mal control group (P＜0 .05).The difference between them has statistical significance (P＜0 .05).The serum levels in active were higher than those in the stable group (P＜0 .05).According to the CT result of sacroiliac joint :the serum levels of LP ,IL-6 ,IL-17 ,IL-23 of patients with level Ⅰ and level Ⅱ were higher than normal control group (P＜0 .05).The difference of serum levels of LP ,IL-6 ,IL-17 ,IL-23 of patients between ≥ Ⅲlevel patients and normal control group has no statistical significance (P＞0 .05).The difference between pa-tients with level Ⅰ,level Ⅱ group and ≥ Ⅲ level group has statistical significance (P＜0 .05).The levels of LP ,IL-6 ,IL-17 ,IL-23 had no statistical significance between HLA-27 positive group and negative group (P＞0 .05).There was a positive correlation between LP ,IL-6 ,IL-17 ,IL-23 and ESR ,CRP ,BASDAI . Conclusion The serum levels of LP ,IL-6 ,IL-17 ,IL-23 in AS patients were significantly higher than healthy persons .And have positive relationship with disease activity indicators .
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