结缔组织病相关肺间质病变患者血清和支气管肺泡灌洗液生物学标志物的表达及其临床意义  

Expression and clinical significance of biomarkers in serum and bronchoalveolar lavage fluid from patients with connective tissue disease-associated interstitial lung disease

作　　者：张继云[1] 穆清爽[1] 赵旌[1] 王梅[1] 李文艳[1] 齐晶[1] 

机构地区：[1]新疆医科大学第二附属医院风湿免疫科,乌鲁木齐市830000

出　　处：《广西医学》2017年第12期1773-1776,共4页Guangxi Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2015211C109)

摘　　要：目的探讨结缔组织病相关肺间质病变(CTD-ILD)患者血清和支气管肺泡灌洗液(BALF)中生物学标志物涎液化糖链抗原-6(KL-6)、单核细胞趋化蛋白-1(MCP-1)、肺泡表面活性蛋白(SP)-A与SP-D的表达水平及其临床意义。方法将60例结缔组织病(CTD)患者分为CTD-ILD组28例及CTD未合并肠间质病变(ILD)组32例,选择20例健康人作为对照组。测定CTD患者血清及BALF、对照组血清KL-6、MCP-1、SP-A、SP-D水平;分析CTD-ILD患者血清及BALF中KL-6、MCP-1、SP-A、SP-D水平与用力肺活量(FVC)、肺一氧化碳弥散量(DLCO)、肺部高分辨率CT评分的相关性。结果对照组、CTD未合并ILD组、CTD-ILD组血清中KL-6、MCP-1、SP-A、SP-D水平依次升高(P<0.05);CTD-ILD组BALF中KL-6、MCP-1、SP-A、SP-D水平均高于CTD未合并ILD组(P<0.05)。CTD-ILD患者血清及BALF中KL-6、MCP-1、SP-A、SP-D水平均与FVC、DLCO呈负相关(均P<0.05),而均与肺部高分辨率CT评分呈正相关(均P<0.05)。结论 CTD-ILD患者血清及BALF的KL-6、MCP-1、SP-A、SP-D呈高表达,联合检测以上指标有助于CTD-ILD的早期诊断及病情评估。Objective To investigate the expression level and clinical significance of Krebs von den Lungen-6（ KL-6）,monocyte chemotactic protein 1（ MCP-1）,surfactant protein（ SP）-A and SP-D in serum and bronchoalveolar lavage fluid（ BALF） from patients with connective tissue disease-associated interstitial lung disease（ CTD-ILD）. Methods Sixty patients with connective tissue disease（ CTD）were divided into CTD-ILD group（ n = 28） and CTD without interstitial lung disease（ ILD） group（ n = 32）. Twenty healthy persons were enrolled as control group. The KL-6,MCP-1,SP-A and SP-D levels were detected in serum and BALF from patients with CTD or in serum from patients in the control group. The correlations of KL-6,MCP-1,SP-A and SP-D levels in serum and BALF with forced vital capacity（ FVC）,diffusion capacity for carbon monoxide of lung（ DLCO）,or high-resolution CT score of the lung were analyzed among patients with CTD-ILD. Results The serum KL-6,MCP-1,SP-A and SP-D levels increased in the order of the control group,the CTD without ILD group and the CTD-ILD group（ P〈0. 05）. The BALF KL-6,MCP-1,SP-A and SP-D levels in the CTD-ILD group were higher than those in the CTD without ILD group（ P〈0. 05）. Among patients with CTD-ILD,the KL-6,MCP-1,SP-A and SP-D levels in serum and BALF negatively correlated with FVC and DLCO（ all P 0. 01）,and positively correlated with high-resolution CT score of the lung（ all P〈0. 05）. Conclusion High expressions of KL-6,MCP-1,SP-A and SP-D are seen in serum and BALF from patients with CTD-ILD. The combined detection of the biomarkers above contributes to early diagnosis and severity evaluation of CTD-ILD.

关 键 词：结缔组织病 肺间质病变 涎液化糖链抗原-6 单核细胞趋化蛋白-1 肺泡表面活性蛋白 血清 支气管肺泡灌洗液 

分 类 号：R563[医药卫生—呼吸系统]