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目的:观察强直性脊柱炎(AS)患者细胞因子/核因子(NF)-κB信号传导通路相关指标的变化,探讨强直性脊柱炎患者血瘀状态形成的机制。方法:采用酶联免疫吸附法(ELISA)检测30例AS患者和30例健康对照外周血血清中肿瘤坏死因子(TNF)-α、白介素(IL)-1β、IL-10、IL-17、核因子激活剂(Act1)、NF-κB抑制蛋白(IκBα)、Ik B激酶(IKKβ)、核转录因子(NF-κB)/P65、NF-κB/P50、血栓素A2(TXA2)、前列环素I2(PGI2)、P-选择素(GMP140或CD62p)、血小板活化因子(PAF)的含量,观察AS患者实验室指标及血瘀症状体征。结果:(1)AS患者外周血血清中的TNF-α、IL-1β、IL-17、Act1、NF-κB/P65、NF-κB/P50、IκBα、IKKβ、GMP140、PAF、TXA2的含量明显高于健康对照组(P<0.05或P<0.01);IL-10、PGI2含量明显低于健康对照组(P<0.05或P<0.01)。AS患者实验室指标血小板(PLT)、纤维蛋白原(FBG)、D-二聚体(D-D)、红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)明显高于健康对照组(P<0.05或P<0.01)。(2)相关性分析显示,AS患者关节刺痛、唇色、舌质、脉象、皮下瘀斑、肌肤甲错、善忘及血瘀症状总积分与PLT、FBG、D-D呈正相关(P<0.05或P<0.01);AS患者TNF-α、IL-1β、IL-17、Act1、IKKβ、IκBα、NF-κB/P65、NF-κB/P50、GMP140、PAF、TXA2、ESR、hs-CRP、VAS、BASDAI与PLT、FBG、D-D、血瘀症状总积分呈正相关(P<0.05或P<0.01);IL-10、PGI2与PLT、FBG、D-D、血瘀症状总积分呈负相关(P<0.05或P<0.01)。结论:AS患者体内存在血瘀状态形成,且与细胞因子紊乱及NF-κB激活有关。细胞因子紊乱/NF-κB信号通路过度活化可能是AS血瘀状态形成的机制。
Objective: To observe the changes of cytokines / nuclear factor (NF) -κB signaling pathways in patients with ankylosing spondylitis (AS) and to explore the mechanism of blood stasis in patients with ankylosing spondylitis. Methods: Serum levels of tumor necrosis factor (TNF) -α, interleukin (IL) -1β, IL-10, IL-17 and nucleus in 30 AS patients and 30 healthy controls were detected by enzyme-linked immunosorbent assay (ELISA) (Act1), NF-κB inhibitor (IκBα), IkB kinase (IKKβ), nuclear factor (NF-κB) / P65, NF- κB / P50, TXA2, I2 (PGI2), P-selectin (GMP140 or CD62p) and platelet activating factor (PAF) in patients with AS were measured. Results: (1) The levels of TNF-α, IL-1β, IL-17, Act1, NF-κB / P65, NF- κB / P50, IκBα, IKKβ, GMP140, PAF and TXA2 in peripheral blood of patients with AS were significantly (P <0.05 or P <0.01). The levels of IL-10 and PGI2 were significantly lower than those in healthy controls (P <0.05 or P <0.01). The laboratory indexes of AS patients were significantly higher than PLT, FBG, DD, erythrocyte sedimentation rate (ESR) and hs-CRP P <0.05 or P <0.01). (2) The correlation analysis showed that the total score of joint pain, lip color, tongue, pulse, subcutaneous ecchymosis, skin error, forgetfulness and blood stasis symptoms were positively correlated with PLT, FBG and DD in AS patients (P <0.05 Or P <0.01). The levels of TNF-α, IL-1β, IL-17, Act1, IKKβ, IκBα, NF-κB / P65, NF-κB / P50, GMP140, PAF, TXA2, ESR, VAS and BASDAI were positively correlated with PLT, FBG and DD, total score of blood stasis syndrome (P <0.05 or P <0.01), IL-10 and PGI2 were negatively correlated with PLT, FBG and DD, 0.05 or P <0.01). Conclusion: There is blood stasis formation in AS patients, which is related to the disorder of cytokines and the activation of NF-κB. Cytokine disorders / NF-κB signaling pathway over-activation may be the formation of AS stasis state mechanism.