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[目的]了解IL-18在活动期强直性脊柱炎(AS)发病中的作用。[方法]53例AS患者,40例正常对照组。活动期AS患者均以非甾体类抗炎药和改善病情药治疗,分别在治疗前、治疗后l2周、24周测外周血IL-18和TNF-d水平,并动态观察临床病情活动指标(BASDAl指数、BASFl指数、BASMl指数)及ESR、CRP变化。[结果](1)治疗前AS患者与正常对照组比较血清IL-l8水平明显升高(P﹤0.05),治疗12周与治疗前比较、治疗24周与治疗12周比较血清IL-18水平均有明显下降(P﹤0.05);(2)所有AS患者治疗后临床病情活动指标(BASDAl指数、BAS-Fl指数、BASMl指数)明显改善(P﹤0.05),Pearson直线相关法分析显示血清IL-18水平与BASDAl、BASFl、BASMl呈正相关(r=0.632,0.583,0.480,P﹤0.05);(3)活动期AS患者治疗前后比较ESR、CRP、TNF-a水平明显下降(P﹤0.05),直线相关分析显示血清IL-18水平与ESR、CRP、TNF-a呈正相关(r=0.520,0-672,0.522,P﹤0.05)。[结论]活动期AS患者血清IL-18、TNF-a水平明显升高,治疗后明显下降,血清IL-18水平与AS病情活动指标呈正相关,提示IL-18可能参与AS的发病,并可作为临床病情活动的指标之一。
[Objective] To investigate the role of IL-18 in the pathogenesis of active ankylosing spondylitis (AS). [Methods] 53 patients with AS and 40 normal control group. Active AS patients were non-steroidal anti-inflammatory drugs and improve the disease drug treatment, respectively, before treatment, after treatment, l2 weeks, 24 weeks of peripheral blood levels of IL-18 and TNF-d and dynamic observation of clinical disease activity indicators (BASDAl index, BASFl index, BASMl index) and ESR, CRP changes. [Results] (1) Compared with the normal control group, the level of serum IL-18 in AS patients before treatment was significantly increased (P <0.05), the level of serum IL-18 in the 12 weeks after treatment was significantly lower than that before treatment (P <0.05); (2) The clinical indicators of activity (BASDAl index, BAS-Fl index, BASMl index) were significantly improved in all AS patients after treatment (P <0.05). Pearson’s linear correlation analysis showed that serum IL (R = 0.632,0.583,0.480, P <0.05). (3) The levels of ESR, CRP and TNF-a in active AS patients before and after treatment were significantly decreased (P <0.05) The linear correlation analysis showed that serum IL-18 level was positively correlated with ESR, CRP and TNF-a (r = 0.520,0-672,0.522, P <0.05). [Conclusion] Serum levels of IL-18 and TNF-a in patients with active AS were significantly increased and decreased significantly after treatment. Serum IL-18 levels were positively correlated with AS activity, suggesting that IL-18 may be involved in the pathogenesis of AS and may As one of the indicators of clinical activity.