血清白细胞介素-33与类风湿关节炎合并肺间质病变相关性研究  

Correlation studies on serum interleukin-33 with rheumatoid arthritis associated interstitial lung disea-se

作　　者：王燕[1] 高薇[1] 王亚媛[1] 冯欣[1] 刘畅[1] 

机构地区：[1]辽宁医学院附属第一医院风湿免疫科,锦州121001

出　　处：《中华风湿病学杂志》2013年第9期591-594,共4页Chinese Journal of Rheumatology

基　　金：辽宁省自然科学基金（20102133）

摘　　要：目的分析类风湿关节炎（RA）合并肺间质病变（ILD）患者血清白细胞介素（IL）-33及其受体人基质裂解素2（ST2）的表达情况及与肺功能等实验室指标的相关性，为其早期诊断提供依据。方法收集2012年3月至2013年3月在我科初诊为RA患者245例，分为RA-ILD组58例与单纯RA组187例，观察各组肺功能等相关实验室指标，另收集我院体检中心健康体检者60名为健康对照组。采用酶联免疫吸附试验（ELISA）法测定以上各组的血清IL-33及ST2浓度水平。组间比较采用两样本t检验；多组间比较采用多个样本均数比较的方差分析；IL-33浓度及相关变量间比较采用Pearson相关分析。结果RA患者ILD发生率为23．7％（58／245）。与健康对照组[（85±38）pg／m1]相比，RA[（433±42）pg／m1]及RA-ILD[（746±43）pg／m1]患者中血清IL-33水平显著增高，差异有统计学意义（P〈0．01）；且与RA组患者相比，RA-ILD组患者血清IL-33及ST2水平升高更为明显（P〈0．01）。RA＊ILD组患者肺活量占预计值百分比（VC％）、用力肺活量占预计值百分比（FVC％）、最大呼气中段流量占预计值百分比（MMF％）和一氧化碳弥散量（DLCO）多项肺功能指标均较RA组患者明显降低，差异有统计学意义（P〈0．01）。IL-33浓度与各实验室指标相关性比较：IL-33浓度与类风湿因子呈正相关（r=0．82，P〈O．01），且与抗环瓜氨酸多肽抗体（ACPA）滴度呈正相关（r=0．55，P〈0．01），而其与DLCO呈负相关（r=-0．80，P〈0．01）。结论IL-33参与RA的发病过程，且可能与RA—ILD的发病相关。Objective To study the association between serum interleukin-33 （IL-33） level and human stromelysin-2（ST2） level in patients with rheumatoid arthritis （RA） associated with interstitial lung disease （RA-ILD） and its correlation with lung function and other laboratory parameters. Methods Two hundred and forty-five newly diagnosed RA patients during March 2012 to March 2013 in the in-patient and out-patient clinic of the First Affiliated Hospital of Liaoning Medical College were enrolled into this study. Patients were further divided into RA group （n=187） and RA-ILD group （n=58）. Sixty subjects who came to the hospital for routine health check-up was composed of the normal control group. The clinical data of the two groups and controls were collected and their serum IL-33 and ST2 concentrations were measured. The t test was used to compare the difference between the two groups. Multiple variance analysis was used to com-pare the difference between groups. Pearson＇s correlation analysis was applied to explore the relationship between IL-33 concen-trations and related variables. Results ① This study showed that the prevalence of RA associated interstitial lung disease was 23.7%（58/245）. ② The concentration of IL-33 [（746±43） pg/ml] and ST2 [（3413±169） pg/ml] of the RA-ILD group was significantly higher than that of the RA group [（433±42） pg/ml, （1500± 147） pg/ml ] （P〈0.01）. ③ The vital capacity （VC%）, forced vital capac-ity （FVC%）, maximal midexpiratary flow curve （MMF%） and carbon monoxide diffusing capacity （DLCO） of the RA-ILD group were significantly lower than those of the RA group. ④ The serum level of IL-33 was negatively correlated with that of RF and ACPA （IL-33 and RF, r=0.82, P〈0.01; IL-33 and ACPA, r=0.55, P〈0.01）. Serum level of IL-33 was negaitively correlated with DLCO （r=-0.80, P〈0.01 ）. Conclusion IL-33 participates in the pathogenesis of RA; and may be involved in the pathogenesis of RA-ILD.

关 键 词：关节炎 类风湿 肺疾病 间质性 呼吸功能试验 白细胞介素类 

分 类 号：R593.22[医药卫生—内科学]