肺泡灌洗液IgG4检测在风湿病相关间质性肺疾病中的临床意义  

The clinical significance of IgG4 in the bronchoalveolar lavage fluid of rheumatic disease related interstitial lung disease

作　　者：徐传辉[1] 周德训[2] 朱雷[1] 安培[2] 穆荣[1] 高占成[2] 栗占国[1] 

机构地区：[1]北京大学人民医院风湿免疫科,100044 [2]北京大学人民医院呼吸内科,100044

出　　处：《中华风湿病学杂志》2012年第12期830-832,共3页Chinese Journal of Rheumatology

基　　金：基金项目：国家自然科学基金（81072412）

摘　　要：目的了解风湿病相关间质性肺疾病（RD-ILD）患者肺泡灌洗液（BALF）中IgG4水平的临床意义。方法连续留取北京大学人民医院18例RD—ILD、14例肺部感染和12例非感染患者的BALF，收集临床及实验室资料。酶联免疫吸试验（ELISA）方法检测BALF中IgG4表达水平，并分析其与BALF细胞分类计数和肺功能指标的相关性。定量资料的统计分析采用t检验，两变量间的相关性分析采用线性回归分析。结果RD—ILD患者BALF中IgG4水平为（87±39）mg／L，显著高于非感染患者的（52±27）mg／L，但与肺部感染患者的（88±65）mg／L比较差异无统计学意义。RD—ILD患者BALF中IgG4水平与淋巴细胞计数比例呈正相关（r=0．53，P=0．03），与巨噬细胞计数比例呈负相关（r=-0．65，P=0．005）。结论RD—ILD患者BALF中的IgG4显著高于非感染患者。IgG4的产生可能主要来源于肺组织中的淋巴细胞。Objective To evaluate the clinical significance of the level of IgG4 in the bronchoalveolar lavage fluid （BALF） of patients with rheumatic disease related interstitial lung disease （RD-ILD）. Methods Eighteen patients with RD-ILD, 14 patients with pulmonary infeetion and 12 patients without ILD or pulmonary infection, were recruited consecutively from the in-patient ward of Peking University People＇s Hospital. Clinical features and-laboratory data were extracted from the medical record database of Peking University People＇s Hospital. The level of IgG4 was determined by ELISA. The statistical analysis of data using t test, and the correlation between the two variables were analyzed using linear regression analysis. Results The level of IgG4 was significantly higher in BALF of patients with RD-ILD than patients＇ without ILD or pulmonary infection, whereas there was no difference compared to patients with pulmonary infection. The level of IgG4 in BALF of patients with RD-ILD was positively correlated with the percentage of lymphocytes （r=-0.53, P=0.03）, and significantly negatively correlated with the percentage of macrophages （r=-0.65, P=0.005 ）. Conclusion The level of IgG4 is significantly elevated in BALF of patients with RD-ILD, which is probably secreted from the lymphocyte of the lung.

关 键 词：风湿性疾病 肺疾病 间质性 免疫球蛋白G 支气管肺泡灌洗液 

分 类 号：R563.9[医药卫生—呼吸系统]