【摘要】 目的 研究高尿酸血症患者血清白细胞介素-41(IL-41)、生长分化因子15(GDF-15)与病情程度的关系。方法 选取2023年1月至2024年12月来院就诊的126例高尿酸血症患者为病例组，另取同期100例健康体检者纳入对照组，对比两组血清IL-41、GDF-15水平。按照《中国高尿酸血症相关疾病诊疗多学科专家共识》标准，将病例组分为轻度组(41例)、中度组(52例)、重度组(33例),检测病例组和对照组血清IL-41、GDF-15水平，采用Pearson相关系数分析血清IL-41、GDF-15表达与血清尿酸的相关性，采用Logistic回归分析患者病情程度的影响因素，绘制受试者工作特征曲线(ROC)分析血清IL-41、GDF-15水平及二者联合检测对病情程度的预测价值。结果 病例组血清IL-41、GDF-15水平高于对照组(P<0.05);重度组血清尿酸、IL-41、GDF-15水平高于中度组、轻度组(P<0.05),中度组血清尿酸、IL-41、GDF-15水平高于轻度组(P<0.05);Pearson相关性分析显示，血清IL-41、GDF-15水平与血清尿酸水平呈正相关(r>0,P<0.05);经Logistic回归分析，结果显示，高血清IL-41(OR=1.062,95%CI:1.035～1.090)、GDF-15(OR=1.151,95%CI:1.085～1.221)、尿酸(OR=1.021,95%CI:1.011～1.033)水平是高尿酸血症患者病情加重的危险因素(P<0.05);绘制ROC曲线，血清IL-41、GDF-15单独及两项联合、尿酸预测高尿酸血症患者病情发展为中重度的AUC分别为0.851(95%CI:0.785～0.916)、0.818(95%CI:0.744～0.892)、0.898(95%CI:0.844～0.951)、0.767(95%CI:0.683～0.851),其中IL-41联合GDF-15的AUC均显著大于IL-41、GDF-15、尿酸的AUC,差异有统计学意义(Z=2.222、2.554、2.770,P=0.026、0.011、0.006)。结论 高尿酸血症患者血清IL-41、GDF-15水平升高，与病情程度呈正相关，临床可通过检测血清IL-41、GDF-15水平预测患者病情变化。更多还原

【Abstract】 Objective To observe the expression pattern of serum interleukin-41(IL-41) and growth differentiation factor-15(GDF-15) in patients with hyperuricemia, and to further analyze the relationship between these markers and the severity of the disease. Methods A total of 126 patients with hyperuricemia who visited our hospital from January 2023 to December 2024 were selected as the case group, while another 100 healthy individuals who underwent physical examinations during the same period were included in the control group. The baseline serum IL-41 and GDF-15 levels of the two groups were detected and compared. According to the standard of multidisciplinary expert consensus on diagnosis and treatment of hyperuricemia-related diseases in China, these patients were divided into mild group(41 cases), moderate group(52 cases) and severe group(33 cases), and the baseline data of all three groups were collected. The baseline serum IL-41 and GDF-15 levels of the three groups were compared, and the correlation between serum IL-41 and GDF-15 expression and serum uric acid was analyzed by Pearson correlation method. Logistic regression was applied to analyze the influencing factors of patients’ illness degree, and receiver operating characteristic curve(ROC) was drawn to evaluate serum levels of IL-41 and GDF-15 and the predictive value of their combination on the illness degree. Results Serum levels of IL-41 and GDF-15 in the case group were significantly higher than those in the control group(P<0.05). Levels of serum uric acid, IL-41 and GDF-15 in severe group were significantly higher than those in moderate group and mild group(P<0.05), and levels of serum uric acid IL-41 and GDF-15 in moderate group were significantly higher than those in mild group(P<0.05). Pearson correlation analysis showed that serum IL-41 and GDF-15 levels were positively correlated with serum uric acid levels(r>0, P<0.05). Logistic regression showed that high serum IL-41(OR=1.062, 95%CI:1.035-1.090), GDF-15(OR=1.151, 95%CI:1.085-1.221), and uric acid(OR=1.021, 95%CI:1.011-1.033) levels were risk factors for the aggravation of hyperuricemia(P<0.05). AUCs of serum IL-41 or GDF-15 alone and in combination, and uric acid for predicting the development of moderate to severe hyperuricemia were 0.851(95%CI:0.785-0.916), 0.818(95%CI:0.744-0.892), 0.898(95%CI:0.844-0.951), and 0.767(95%CI:0.683-0.851), respectively. Among them, the AUC of IL-41 combined with GDF-15 was significantly greater than that of IL-41, GDF-15, and uric acid(Z=2.222, 2.554, 2.770, P=0.026, 0.011, 0.006). Conclusion Serum IL-41 and GDF-15 are highly expressed in patients with hyperuricemia, and their expressions are positively correlated with the severity of the disease. Clinical observation of serum IL-41 and GDF-15 levels can help to predict changes of patients’ condition.更多还原