摘要目的:研究强直性脊柱炎（Ankylosing spondylitis，AS）患者血清肿瘤坏死因子（Tumor necrosis factor，TNF）-α、白细胞介素（Interleukin，IL）-6及淋巴亚群的表达水平，探讨其临床意义。方法:应用流式荧光法检测2014年3月至2020年7月本科住院及门诊确诊的AS患者（ n=56）和正常对照者（ n=50）血清中TNF-α、IL-6水平，应用流式细胞术检测淋巴细胞亚群细胞比例（CD4 +T、CD8 +T、B、NK），并随访AS患者接受生物制剂依那西普治疗前后的血清TNF-α、IL-6水平，比较分析其与病情活动指标的关系。 结果:AS患者血清TNF-α、IL-6、CD4 +T、B细胞比例显著高于正常对照组［分别为（66.18±63.69）pg/ml比（6.09±1.44）pg/ml ，（15.68±12.81）pg/ml比（2.11±0.76）pg/ml，（43.50±4.60）%比（30.40±1.80）%，（12.40±3.60）%比（8.80±3.50）%，均 P＜0.05］。CD8 +T及NK细胞比例显著低于正常对照组［（17.50±5.70）%比（23.70±6.10）%，（4.00±1.40）%比（15.10±5.80）%，均 P＜0.05］。AS活动期患者IL-6、CRP及红细胞沉降率（Erythrocyte sedimentation rate，ESR）水平明显高于稳定期［（31.40±28.50）pg/ml比（4.40±3.73）pg/ml，（56.55±54.60）mg/L比（5.70±4.08）mg/L，（82.68±33.22）mm/h比（25.67±23.01）mm/h，均 P＜0.05］。经过治疗后患者TNF-α、IL-6及临床病情活动指标较前下降。相关分析发现TNF-α、IL-6及CD4 +T与临床病情活动指标间有正相关（ P＜0.05）。 结论:血清TNF-α及IL-6水平与AS病情活动相关，提示其可能参与AS的炎症反应，AS患者外周血淋巴细胞亚群平衡失控和细胞免疫紊乱。

abstractsObjective:To investigate the clinical significance of serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and lymphocyte subsets in patients with ankylosingspondylitis (AS).Methods:The flow fluorescence method was applied to detect the serum levels of TNF-α and IL-6 in 56 patients with AS diagnosed at our hospital and 50 normal controls from March, 2014 to July, 2020. The percentages of lymphocyte subgroups (CD4 +T, CD8 +T, B, and NK cells) were detected by flow cytometry in the patients and the normal controls. The levels of TNF-α and IL-6 in the AS patients before and after the treatment with etanercept were recorded. The correlation of levels of TNF-α and IL-6 with disease activity indicators was analyzed. Results:The serum levels of TNF-α and IL-6 and the percentages of CD4 + T and B cell were significantly higher in the patients with AS than in the normal controls[(66.18±63.69) pg/ml vs. (6.09±1.44) pg/ml, P=0.021; (15.68±12.81) pg/ml vs. (2.11±0.76) pg/ml, P=0.016; (43.50±4.60)% vs. (30.40±1.80)%, P=0.029; and (12.40±3.60)% vs. (8.80±3.50)%, P=0.032]. The percentages of CD8 + T and NK cells were significantly lower in the AS patients than in the normal controls [(17.50±5.7)% vs. (23.70±6.10)%, P=0.001; (4.00±1.40)% vs. (15.10±5.80)%, P=0.003]. The levels of IL-6 and C-reactive protein and the erythrocyte sedimentation rate were significantly higher the patients with AS in active phase than in the patients in stable phase [(31.40±28.50) pg/ml vs. (4.40±3.73) pg/ml, P=0.042; (56.55±54.60) mg/L vs. (5.70±4.08) mg/L, P=0.047; and (82.68±33.22) mm/h vs. (25.67±23.01) mm/h, P=0.014]. After etanercept treatment, the levels of TNF-α and IL-6 and the clinical disease activity indicators decreased in the patients. Correlation analysis showed that TNF-α, IL-6, and CD4 + T cell percentage were positively correlated with the clinical disease activity indicators (all P＜0.05). Conclusion:Serum TNF-α and IL-6 levels are related to the activity of AS, suggesting that they may be involved in the inflammatory response of AS. AS patients are unbalanced in T lymphocyte subgroups in peripheral blood and are disorder in cellular immune.