| Objective:1.To measure the serum level of interleukin-1beta(IL-1β) in patients with gout and to study its role in the pathogenesis of gout;2. To improve the recognition of sacroiliac joint lesions in patients with gout.Methods :Choose 77 patients with gout in our hospital from December, 2013 to March, 2013,and the clinical datas were analyzed retrospectively.They are in line with the American Rheumatic Association(ACR) 1977 to formulate the diagnostic criteria of primary gout.30 health subjects matched as control group.The data of population census and other data was studied.The concentration of UA、FBG、TC, TG, HDL-C as well as LDL-C was determined by using automatic biochemistry analyzer.Statistical analysis was done by SPSS 23.0 software to compare the differences of each value between groups and analyze gout associated risk factors.Using competitive enzyme-linked immunosorbent assay(ELISA) to detect changes in the level of serum IL- 1 beta,constituting the comparison of three groups of subjects IL- 1 beta expression differences, and the various factors which may affect the expression were analyzed statistically.Further studies are needed to collection clinical data including course, the first affected joints, the affected joints, low back pain, heel pain, and imaging data of sacroiliac joints(CT).All patients need Serological surveillance to confirm or exclude the diagnosis of the rest of the rheumatism.To explore and assess the CT features ofsacroiliac joint in gout,meanwhile, analysis its association with Course, uric acid level,IL- 1 beta.Results:1. the characteristics of the first affected joint and the analysis of risk factors in gout.It occurred in 2 femaleand 75 male patients.19 patients had low back pain and 32 cases had heel pain.Chronic gout patients course of disease is longer than the intermittent period group(P < 0.05);The gout group of BMI,UA,total triglyceride were evidently higher than those of the normal subjects(P<0.05);The serum concentration of uric acid in Chronic gout was higher than of the intermittent period group(P <0.05).Pearson correlation analysis showed that body mass index, triglycerides were positively related to blood uric acid(P< 0.05).HDL and uric acid value has a negative correlation(P<0.01),.And fasting glucose, total cholesterol, low-density lipoprotein cholesterol(ldl-c) have no significant relation with UA(P > 0.05).2.The difference of the level of serum IL- 1 betaThe Gout groups of serum IL- 1 beta levels were higher than healthy controls(all P < 0.05), The levels of Serum IL- 1 beta with UA have positively correlation(P <0.01).3.The CT features of sacroiliac jointIn 73 patients with gout,Grade I and above changes in the sacroiliac joint CT have43 cases(58.9%),as follows:the level 0, 16 cases(21.9%), grade I 14 cases(19.2%) and grade II 30 cases(41.1%), grade III 13 cases(17.8%), level IV(0, 0.00%).The CT manifestations of sacroiliac joint lesions and course, uric acid values are positively correlated(P < 0.01).In 46 patients with gout have 3 cases of RF(+)(4.3%), 1 case of HLA-B27(+)(1.4%), 4 cases of ANA(+)(5.7%).According the standard of ESSG,7subjects(18.4%) in 38 gout patients diagonosis Spa, and 11 patients(28.9) conforms to the diagnostic criteria of Amor.Conclusion:1. High uric acid level and long duration of gout are more likely to develop chronic gouty arthritis;2.Gout is inflammatory arthropathy, IL- 1 beta as inflammatory factors involved in the occurrence and development of gout, it can be as therapeutic targets for the treatment of gouty arthritis.3.Gout patients prone to have the change of the sacroiliac joints, it is given priority to with grade II, III.The longer courses of disease and the higher uric acid level,the more serious does the sacroiliac joint damage.The change of the sacroiliac joints may be associated with gout, we need further study and raise awareness in the clinical. |
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