Ⅱ期结节病中SACE与免疫炎症指标、影像表现及肺功能的相关性研究  

Correlation between serum angiotensin converting enzyme activity and immune inflammation indexes,imaging features and lung function in stageⅡsarcoidosis

作　　者：陈凤芳 马俊[2] 王琳[3] 黄劲 杨光红 冯永红[2] Chen Fengfang;Ma Jun;Wang Lin;Huang Jin;Yang Guanghong;Feng Yonghong(School of Public Health,Guizhou Medical University,Key Laboratory of Environmental Pollution and Disease Control,Ministry of Education,Guiyang 550025,China;Shanghai Key Laboratory of Tuberculosis,Clinic and Research Center of Tuberculosis,Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai 200433,China;Department of Radiology,Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China)

机构地区：[1]贵州医科大学公共卫生学院环境污染与疾病监控教育部重点实验室,贵阳550025 [2]上海市结核病(肺)重点实验室结核病临床研究中心同济大学附属上海市肺科医院,200433 [3]上海市(复旦大学附属)公共卫生临床中心影像科,201508

出　　处：《国际呼吸杂志》2020年第12期922-928,共7页International Journal of Respiration

基　　金：国家自然科学基金(81471563、81771692、81971558)。

摘　　要：目的比较Ⅱ期结节病中高血清血管紧张素转化酶(SACE)水平与正常SACE水平患者间临床、免疫炎症指标、影像表现及肺功能参数的差异。方法对2008-2018年在上海市肺科医院住院就诊的274例Ⅱ期结节病患者的临床数据进行回顾性分析,分析结节病中SACE升高组和正常组间的临床、免疫炎症指标、影像表现及肺功能的差异,分析SACE与免疫炎症指标、影像表现及肺功能参数间的相关性。结果在SACE升高组和SACE正常组中均合并有较高比例的高血压,分别为18.00%、18.39%,差异无统计学意义。在免疫炎症指标上,SACE升高组中单核细胞比例、血小板/淋巴细胞数、可溶性白细胞介素2受体及肿瘤坏死因子α显著高于正常组(t值分别为-4.58、-3.23、-5.60、-3.07,P值均<0.05),且SACE水平与可溶性白细胞介素2受体、单核细胞比例、肿瘤坏死因子α、血小板/淋巴细胞数存在不同程度相关性(r值分别为0.58、0.32、0.22、0.13,P值均<0.05)。对2组间影像学指标进行比较,发现SACE升高组中小叶间隔增厚的发生率和肺部损伤区域数显著高于SACE正常组(χ^2=7.90,t=3.02,P值均<0.05)。肺功能参数上SACE升高组中第1秒用力呼气容积/用力肺活量、肺一氧化碳弥散量占预计值百分比均低于SACE正常组(t值分别为2.00、2.05,P值均<0.05)。结论Ⅱ期结节病患者中,SACE升高组的可溶性白细胞介素2受体、单核细胞比例、血小板与淋巴细胞的比率、肿瘤坏死因子α等炎症指标高于SACE正常组,且SACE水平与这些炎症指标存在显著相关性。在CT上小叶间隔增厚、肺部损伤区域数与SACE相关,SACE较高的患者更倾向于表现较多的肺部损伤和较低的肺功能。Objective To compare the differences of clinical,immuno-inflammatory,imaging features and pulmonary function parameters between stageⅡsarcoidosis patients with high and normal serum angiotensin converting enzyme(SACE)activities.Methods The clinical records of 274 patients with stageⅡsarcoidosis were retrospectively analyzed,who were first admitted to Shanghai Pulmonary Hospital from 2008 to 2018.The differences of clinical,immune inflammation,imaging manifestation and pulmonary function between the elevated and normal SACE groups in sarcoidosis,and the correlation between SACE and immune inflammation indexes,imaging manifestation and pulmonary function parameters were analyzed.Results Proportion of hypertension in the elevated and normal SACE groups were 18.00%and 18.39%,respectively,with no statistical difference.The proportion of monocytes,platelet-to-lymphocyte ratio,soluble interleukin-2 receptor and tumor necrosis factor-αin the elevated SACE group were significantly higher than those in the normal group(t=-4.58,-3.23,-5.60,-3.07,respectively,all P<0.05).The SACE level was correlated with soluble interleukin-2 receptor,the proportion of monocytes,tumor necrosis factor-α,and platelet-to-lymphocyte ratio(r=0.58,0.32,0.22,0.13,respectively,all P<0.05).The incidence of interlobular septal thickening and infiltrated zones of lung in the elevated SACE group were significantly higher than those in the normal SACE group(χ^2=7.90,t=3.02,all P<0.05).The forced expiratory volume in one second/forced vital capacity,percentage of predicted value of diffusion capacity for carbon monoxide of lung in the elevated SACE group were significantly lower than those in the normal SACE group(t=2.00,2.05,respectively,all P<0.05).Conclusions In patients with stageⅡsarcoidosis,the levels of soluble interleukin-2 receptor,the proportion of monocytes platelet-to-lymphocyte ratio and tumor necrosis factor-αin elevated SACE group are higher than those in normal SACE group,and the level of SACE is significantly correlated with th

关 键 词：结节病 血清血管紧张素转化酶 免疫指标 电子计算机断层扫描 肺功能 

分 类 号：R593.9[医药卫生—内科学]