系统性红斑狼疮伴肺部损害的CT定量参数与抗核抗体谱的相关研究  

Correlation Between Quantitative CT Parameters and Antinuclear Antibody Spectrum in Systemic Lupus Erythematosus with Lung Damage

作　　者：叶玲 阮莉金 潘庆军 何滨 YE Ling;RUAN Lijin;PAN Qingjun;HE Bin(Department of Radiology,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524003,China;不详)

机构地区：[1]广东医科大学附属医院放射科,广东湛江524003 [2]广东医科大学附属医院肾病研究所,广东湛江524003

出　　处：《中国医学影像学杂志》2021年第5期459-463,共5页Chinese Journal of Medical Imaging

基　　金：广东省自然科学基金项目(2019A1515012203);广东省重点平台及科研项目(2017KTSCX077)。

摘　　要：目的探讨系统性红斑狼疮(SLE)伴肺部损害患者CT定量参数与血清抗核抗体谱的相关性。资料与方法选择经病理确诊为SLE患者94例并加以免疫药物治疗。根据患者是否存在肺部损害将其分为肺部损害组36例和肺部无损害组58例,分别检测患者治疗前后7 d CT扫描结果与血清抗体谱变化情况。采用多层螺旋CT扫描及后处理技术获得肺部损害G值和肺小血管截面积与肺截面积比值(%CSA)等定量参数;采用免疫印迹法检测血清抗核抗体(ANA)、抗双链DNA抗体(ds-DNA)和抗可溶性抗原抗体(ENA)表达水平;分析G值、%CSA值与血清ANA、ds-DNA、ENA定量水平的相关性。结果与无损害组相比,损害组患者G值、%CSA值以及ANA、ds-DNA和ENA水平均显著升高,差异有统计学意义(P<0.05);且肺部损害组患者治疗后G值、%CSA值、ANA抗体水平、ds-DNA抗体水平和ENA抗体水平均显著下降,差异有统计学意义(P<0.05)。G值分别与血清ANA、ds-DNA和ENA定量水平呈显著正相关(r=0.754、0.863、0.735,P<0.05);%CSA值也与其呈正相关(r=0.698、0.821、0.709,P<0.05)。结论SLE伴肺部损伤患者CT定量参数G值和肺动脉高压患者%CSA值均与血清抗核抗体谱存在显著相关性,对临床诊断和病情评估具有重要意义。Purpose To explore the correlation between CT quantitative parameters and serum antinuclear antibody spectrum in patients of systemic lupus erythematosus(SLE)with lung damage.Materials and Methods A total of 94 patients with pathological diagnosis of SLE were prospectively selected and treated with immune-drug therapy.And all patients were divided into 36 cases of lung damage group and 58 cases of lung non-damage group according to the situation of lung damage.The alterations at 7 days pre-and post-treatment,including CT imaging and serum antibody spectrum,were respectively detected and recorded.Quantitative parameters such as G value and%CSA value of lung damage were obtained via multi-slice spiral CT scan and post-processing technology.The expression levels of anti-nuclear antibody(ANA),anti-double-stranded DNA antibody(ds-DNA)and anti-soluble antigen antibody(ENA)in serum were detected by Western blotting.The correlations between G value,%CSA value and the quantitative levels of ANA,ds-DNA and ENA in serum were analyzed,respectively.Results The values G and%CSA,the levels of ANA,ds-DNA,and ENA in the lung damage group were significantly higher than that in the no-lung damage group(P<0.05).In addition,the values G and%CSA,the levels of ANA,ds-DNA,and ENA in the post-treatment lung damage group were significantly decreased relative to the pre-treatment lung damage group(P<0.05).G value was significantly positive correlated with the levels of ANA,ds-DNA and ENA(r=0.754,0.863,0.735,P<0.05),and%CSA value was also significantly positive associated with the levels of ANA,ds-DNA and ENA(r=0.698,0.821,0.709,P<0.05).Conclusion The G value of CT quantitative parameter and%CSA value of pulmonary arterial hypertension in SLE patients with lung injury are significantly correlated with the spectrum of antinuclear antibodies in the serum,indicating the great significance of clinical diagnosis and disease assessment.

关 键 词：红斑狼疮 系统性 肺炎 体层摄影术 螺旋计算机 肺动脉高压 抗核抗体谱 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]