眼眶炎性假瘤患者血清IL-6、TNF-α水平与糖皮质激素敏感性的关系

任晓磊; 宫朝举; 周雷; 章志扬; 李威

doi:10.16766/j.cnki.issn.1674-4152.004200

眼眶炎性假瘤患者血清IL-6、TNF-α水平与糖皮质激素敏感性的关系

doi: 10.16766/j.cnki.issn.1674-4152.004200

1.
徐州市第一人民医院徐州医科大学附属徐州市立医院徐州市眼病防治研究所眼科，江苏徐州 221002
2.
徐州市第一人民医院中心实验室，江苏徐州 221002

基金项目:

国家自然科学基金项目 82103334

详细信息

通讯作者:
李威，E-mail：liweigyz@126.com

中图分类号: R739.72
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出版历程
- 收稿日期: 2025-03-11

The relationship of IL-6 and TNF-α levels with glucocorticoid sensitivity in patients with idiopathic Orbital inflammatory pseudotumor

1.
Xuzhou First People ' s Hospital, Xuzhou Municipal Hospital Affiliated to XuzhouMedical University, Xuzhou Eye Ophthalmology Department, Xuzhou Eye Disease Prevention and Treatment Research Institute Disease Prevention and Treatment Research Institute Ophthalmology, Xuzhou, Jiangsu 221002, China

摘要

摘要: 目的探讨眼眶炎性假瘤(IOIP)患者血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平与糖皮质激素敏感性的关系。方法选取2020年1月—2023年1月徐州市第一人民医院收治的97例IOIP患者，根据糖皮质激素敏感性分为糖皮质激素敏感组(62例)及抵抗组(35例)，比较2组IL-6、TNF-α水平及疾病活动性，分析相关性，采用ROC曲线评估各指标对糖皮质激素敏感性的预测价值。结果抵抗组血清IL-6、TNF-α水平及活动期患者占比[(2.24±0.28)pg/mL、(1.95±0.22)pg/mL、65.71%(23/35)]均高于敏感组[(1.89±0.33)pg/mL、(1.45±0.31)pg/mL、43.55%(27/62)，P＜0.05]。敏感组活动期患者血清IL-6、TNF-α水平均高于非活动期患者(P＜0.05)；抵抗组活动期患者血清IL-6、TNF-α水平均高于非活动期患者(P＜0.05)。Spearman相关分析显示，IL-6、TNF-α水平与IOIP患者疾病活动性均呈正相关关系(r=0.433、0.396，P＜0.05)。ROC曲线显示，IL-6、TNF-α水平预测糖皮质激素敏感性的曲线下面积分别为0.689、0.698(P＜0.05)。结论血清IL-6、TNF-α在糖皮质激素抵抗IOIP患者中表达较高，可预测糖皮质激素敏感性。
- 眼眶炎性假瘤 /
- 白介素-6 /
- 肿瘤坏死因子-α /
- 糖皮质激素敏感性
Abstract: Objective To investigate the relationship between serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) levels, and glucocorticoid sensitivity in patients with idiopathic orbital inflammatory pseudotumor (IOIP). Methods A total of 97 IOIP patients admitted to Xuzhou First People ' s Hospital from January 2020 to January 2023 were selected and divided into the glucocorticoid-sensitive group (n=62) and the resistance group (n=35) according to glucocorticoid sensitivity. The levels of IL-6 and TNF-α and disease activity were observed, the correlation was analyzed. The ROC curve was used to evaluate the predictive value of each index for the sensitivity of glucocorticoids. Results The serum levels of IL-6 and TNF-α in the resistance group and the proportion of patients in the active stage [(2.24±0.28) pg/mL, (1.95±0.22) pg/mL, 65.71% (23/35)] were higher than those in the sensitive group [(1.89±0.33) pg/mL, (1.45±0.31)pg/mL, 43.55%(27/62), P < 0.05]. The serum levels of IL-6 and TNF-α in the active patients in the sensitive group were higher than those in the inactive patients (P < 0.05); the serum levels of IL-6 and TNF-α in the active patients in the resistance group were higher than those in the inactive patients (P < 0.05). Spearman correlation analysis showed that the levels of IL-6 and TNF-α were positively correlated with the disease activity in the IOIP patients (r=0.433, 0.396, P < 0.05). ROC curve showed that IL-6 and TNF-α levels predicted glucocorticoid sensitivity with a score below the curve of 0.689 and 0.698 (P < 0.05). Conclusion Serum IL-6 and TNF-α expression is higher in patients with glucocorticoid resistance to IOIP, which can predict glucocorticoid sensitivity.
- Idiopathic orbital inflammatory pseudotumor /
- Interleukin-6 /
- Tumor necrosis factor-α /
- Glucocorticoid sensitivity
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图 1 IL-6、TNF-α水平预测糖皮质激素敏感性的ROC曲线

Figure 1. ROC Curve analysis of IL-6 and TNF-α in predicting response to glucocorticoids

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表 1 不同糖皮质激素敏感性IOIP患者临床资料比较

Table 1. Comparison of clinical data of IOIP patients with different glucocorticoid sensitivities

组别	例数	性别(例)		年龄(x ±s，岁)	病程(x ±s，月)	疾病部位(例)
组别	例数	男性	女性	年龄(x ±s，岁)	病程(x ±s，月)	单眼	双眼
敏感组	62	29	33	41.22±3.08	3.56±0.45	48	14
抵抗组	35	14	21	40.98±3.11	3.39±0.67	29	6
统计量		0.416^a		0.367^b	1.491^b	0.404^a
P值		0.519		0.714	0.139	0.525
注：^a为χ²值，^b为t值。

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表 2 不同糖皮质激素敏感性IOIP患者血清IL-6、TNF-α水平及疾病活动性比较

Table 2. Comparison of serum IL-6 and TNF-α levels and disease activity in IOIP patients with different glucocorticoid sensitivities

组别	例数	IL-6 (x ±s，pg/mL)	TNF-α (x ±s，pg/mL)	疾病活动期[例(%)]
敏感组	62	1.89±0.33	1.45±0.31	27(43.55)
抵抗组	35	2.24±0.28	1.95±0.22	23(65.71)
统计量		5.289^a	8.412^a	4.401^b
P值		＜0.001	＜0.001	0.036
注：^a为t值，^b为χ²值。

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表 3 不同疾病时期IOIP患者血清IL-6、TNF-α水平比较(x ±s，pg/mL)

Table 3. Comparison of serum IL-6 and TNF-α levels in IOIP patients at different disease stages(x ±s, pg/mL)

组别	例数	IL-6	TNF-α
活动期	50	2.33±0.37	2.04±0.26
非活动期	47	1.78±0.27	1.11±0.29
t值		8.318	16.649
P值		＜0.001	＜0.001

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表 4 敏感组疾病不同疾病时期IOIP患者治疗前后血清IL-6、TNF-α水平比较(x ±s，pg/mL)

Table 4. Comparison of serum IL-6 and TNF-α levels across different disease stages in sensitive-group IOIP patients, before and after treatment(x ±s, pg/mL)

组别	例数	IL-6		t值	P值	TNF-α		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
活动期	27	2.11±0.29	1.21±0.21	18.706	＜0.001	1.88±0.24	0.83±0.16	27.280	＜0.001
非活动期	35	1.72±0.36	1.13±0.34	10.947	＜0.001	1.07±0.36	0.77±0.12	7.395	＜0.001
统计量		4.593^a	0.410^b			10.081^a	0.410^b
P值		＜0.001	0.525			＜0.001	0.128
注：^a为t值，^b为F值。

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表 5 抵抗组疾病不同疾病时期IOIP患者治疗前后血清IL-6、TNF-α水平比较(x ±s，pg/mL)

Table 5. Comparison of serum IL-6 and TNF-α levels across different disease stages in resistant-group IOIP patients, before and after treatment(x ±s, pg/mL)

组别	例数	IL-6		t值	P值	TNF-α		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
活动期	23	2.59±0.44	1.09±0.23^a	21.474	＜0.001	2.23±0.28	0.73±0.11	36.891	＜0.001
非活动期	12	1.57±0.03	0.96±0.17^a	36.088	＜0.001	1.21±0.11	0.69±0.12	26.751	＜0.001
统计量		7.964^a	1.123^b			12.072^a	0.286^b
P值		＜0.001	0.297			＜0.001	0.595
注：^a为t值，^b为F值。

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表 6 不同糖皮质激素敏感性患者不同疾病活动期血清IL-6、TNF-α水平比较(x ±s，pg/mL)

Table 6. Comparison of serum IL-6 and TNF-α levels across different disease stages in sensitive-group IOIP patients(x ±s, pg/mL)

组别	例数	活动期		例数	非活动期
组别	例数	IL-6	TNF-α	例数	IL-6	TNF-α
敏感组	27	2.11±0.29	1.88±0.24	35	1.72±0.36	1.07±0.36
抵抗组	23	2.59±0.44	2.23±0.28	12	1.57±0.03	1.21±0.11
t值		4.616	4.761		1.431	1.318
P值		＜0.001	＜0.001		0.159	0.194

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表 7 IL-6、TNF-α水平预测糖皮质激素敏感性的效能

Table 7. The efficacy of IL-6 and TNF-α levels in predicting the sensitivity of glucocorticoids

项目	cut-off值	AUC	95% CI	约登指数	灵敏度(%)	特异度(%)	P值
IL-6	≤2.21 pg/mL	0.689	0.587~0.779	0.382	83.87	54.29	0.001
TNF-α	≤1.67 pg/mL	0.698	0.597~0.787	0.420	67.74	74.29	< 0.001

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