摘要目的 观察急、慢性期布鲁菌病(简称布病)患者抗生素治疗前和治疗后外周血骨吸收相关细胞因子[白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、肿瘤坏死因子 α(TNF-α)]水平,评估急、慢性期布病治疗前和治疗后骨吸收状况.方法 采用成组设计,抽取2017年1-4月乌兰察布市地方病防治中心抗生素治疗前和治疗后急、慢性期布病患者各36名作为研究对象,以当地健康人群25名作为对照.采用酶联免疫吸附法测定治疗前和治疗后上述各组人群血清IL-6、IL-17、TNF-α 水平.结果 治疗前,急、慢性期布病组和对照组人群血清IL-6水平分别为(23.19±2.51)、(21.93±2.27)、(14.52±2.08)ng/L,IL-17水平分别为(23.55±2.24)、(21.43±2.44)、(13.69±1.85)ng/L,TNF-α 水平分别为(478.97±47.11)、(434.67±42.11)、(290.19±34.67)ng/L,3组间IL-6、IL-17、TNF-α 水平比较,差异有统计学意义(F=113.91、152.88、153.49,P均<0.01);与对照组比较,急、慢性期布病组IL-6、IL-17、TNF-α 水平明显升高(P均<0.05);与慢性期布病组比较,急性期布病组IL-6、IL-17、TNF-α 水平明显升高(P均<0.05).治疗后,急、慢性期布病组和对照组人群血清IL-6水平分别为(17.83±2.31)、(18.45±2.15)、(14.52±2.08)ng/L;IL-17水平分别为(17.58±2.21)、(18.56±2.29)、(13.69±1.85)ng/L;TNF-α 水平分别为(370.73±41.04)、(375.46±44.61)、(290.19±34.67)ng/L,3组间IL-6、IL-17、TNF-α 水平比较,差异有统计学意义(F=25.94、39.96、38.30,P均<0.01);与对照组比较,急、慢性期布病组IL-6、IL-17、TNF-α 水平明显升高(P均<0.05);慢性期布病组与急性期布病组IL-6、IL-17、TNF-α 水平比较差异无统计学意义(P均>0.05).结论 急性期布病治疗前骨吸收相关细胞因子IL-6、IL-17、TNF-α 水平明显高于慢性期布病患者,抗生素治疗能明显降低其水平,可能会影响布病患者的骨吸收.

abstractsObjective To observe interleukin-6 (IL-6), interleukin-17 (IL-17), and tumor necrosis factor-α(TNF-α) levels in acute and chronic brucellosis before and after antibiotics treatment in order to assess the bone resorption. Methods Using group design, 36 acute and 36 chronic brucellosis before antibiotics treatment, and 36 acute and 36 chronic brucellosis after antibiotics treatment from the Endemic Disease Prevention and Control Center of Ulanqab City were selected as the research subjects, with 25 local healthy persons as the healthy control group from January to April 2017. Enzyme linked immunosorbent assay (ELISA) method was used to determine the serum levels of IL-6, IL-17, and TNF-α in acute brucellosis, chronic brucellosis and control groups before and after antibiotics treatment. Results The means of IL-6 [(23.19 ± 2.51), (21.93 ± 2.27), (14.52 ± 2.08) ng/L], IL-17 [(23.55 ± 2.24), (21.43 ± 2.44), (13.69 ± 1.85) ng/L], and TNF-α [(478.97 ± 47.11), (434.67 ± 42.11), (290.19 ± 34.67) ng/L] were significantly different in the acute brucellosis, chronic brucellosis and control groups before antibiotics treatment (F = 113.91, 152.88, 153.49, P < 0.01); compared to control group, the levels of IL-6, IL-17,&nbsp;and TNF -α in acute brucellosis and chronic brucellosis groups were significantly increased before antibiotics treatment (P < 0.05); the levels of IL-6, IL-17, and TNF-α in acute brucellosis group were significantly increased compared to those of chronic brucellosis group before antibiotics treatment (P < 0.05). The means of IL-6 [(17.83 ± 2.31), (18.45 ± 2.15), (14.52 ± 2.08) ng/L], IL-17 [(17.58 ± 2.21), (18.56 ± 2.29), (13.69 ± 1.85) ng/L], and TNF-α[(370.73 ± 41.04), (375.46 ± 44.61), (290.19 ± 34.67) ng/L] were significantly different in the acute brucellosis, chronic brucellosis and control groups after antibiotics treatment (F = 25.94, 39.96, 38.30, P < 0.01); compared to the control group, the levels of IL-6, IL-17, and TNF-α in acute brucellosis and chronic brucellosis groups were significantly increased after antibiotics treatment (P < 0.05); the levels of IL-6, IL-17, and TNF-α in acute brucellosis group were not significantly different compared to those of the chronic brucellosis group after antibiotics treatment (P > 0.05). Conclusions This study shows that before antibiotics treatment, the bone resorption-related cytokines IL-6, IL-17, and TNF-α of acute brucellosis are higher than those of chronic brucellosis. Antibiotic treatment can significantly reduce their levels and may affect bone resorption in patients with brucellosis.