全球精选文摘 - 巨细胞动脉炎患者长期随访中循环细胞因子(肿瘤坏死因α和白介素-6)水平持续升高的临床相关性

Clinical relevance of persistently elevated circulating cytokines (tumor necrosis factor α and interleukin-6) in the long-term followup of patients with giant cell arteritis

García-Martínez, A, Hernández-Rodríguez, J, Espígol-Frigolé, G 2010/10/22 15:16:39

【发表评论】【全球专家评论】

打印| 推荐给好友

Arthritis Care Res (Hoboken) , 2010,

专家评级：

★

循证评级：

View at Publisher

bjective:
To assess the clinical relevance of increased circulating cytokines in patients with giant cell arteritis (GCA) after long-term followup.

Methods:
We performed a cross-sectional evaluation of 54 patients with biopsy-proven GCA prospectively followed for a median of 5.4years (range 4-10.5years). GCA-related complications, vascular events, relapses, current prednisone dose, time required to achieve a maintenance prednisone dosage <10mg/day, cumulated prednisone at that point, and adverse effects during followup were recorded. Serum interleukin-6 (IL-6) and tumor necrosis factor α (TNFα) were determined by immunoassay.

Results:
All patients were in clinical remission. Both cytokines were significantly higher in patients than in controls (mean±SD 21±35 versus 5±11pg/ml; P<0.001 for IL-6 and mean±SD 32±14 versus 16±9pg/ml; P<0.001 for TNFα). No differences were found in patients with or without GCA-related complications or vascular events during followup. Circulating cytokines were significantly higher in patients who had experienced relapses (mean±SD 25±39 versus 10±11pg/ml; P=0.04 for IL-6 and mean±SD 34±15 versus 25±11pg/ml; P=0.042 for TNFα). IL-6 was significantly higher in patients still requiring prednisone (mean±SD 29±45 versus 13±17pg/ml; P=0.008), and TNFα correlated with cumulated prednisone dose (r=0.292, P=0.04). No significant relationship was found between elevated cytokines and prednisone adverse effects or patients' quality of life.

Conclusion:
Circulating TNFα and IL-6 may persist elevated in GCA patients after long-term followup and remain higher in patients who have experienced more relapsing disease. However, in this patient cohort, elevated circulating cytokines were not associated with increased frequency of GCA complications, vascular events, or treatment-related side effects.

请登录后发表评论，点击此处登录。

全部学科

疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

更多>>>

医学数据库