ⅣC、HA与类风湿性关节炎继发间质性肺病的相关性研究  

Correlation ofⅣC and HA with rheumatoid arthritis related interstitial lung disease

作　　者：孙慧莹 刘晓敏[1] 王永福[2] 鲁芙爱 SUN Hui-ying;LIU Xiao-min;WANG Yong-fu;LU Fu-ai(Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014010,China;Department of Rheumatology,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014010,China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014010 [2]内蒙古科技大学包头医学院第一附属医院风湿免疫科,内蒙古包头014010

出　　处：《临床肺科杂志》2022年第2期174-178,共5页Journal of Clinical Pulmonary Medicine

基　　金：包头医学院科学研究基金项目(No.BYJJ-YF201690)。

摘　　要：目的检测类风湿关节炎继发间质性肺病(RA-ILD)患者血清层粘连蛋白(LN)、三型前胶原N端肽(PⅢNP)、四型胶原(ⅣC)、透明质酸(HA)的水平并探究其与各指标的关联性。方法选取2018年3月-2020年12月本院收治的RA-ILD患者65例,非ILD的RA患者(N-RA-ILD)及健康人各40例,化学发光法检测血清LN、PⅢNP、ⅣC、HA水平,并探究其与RA-ILD各指标相关性。结果三组患者LN水平无显著差异(P>0.05)。RA-ILD及N-RA-ILD组PⅢNP水平无差异(P>0.05),但均高于健康组(P<0.05)。RA-ILD组ⅣC、HA水平显著高于N-RA-ILD组及健康组(P<0.001)。N-RA-ILD组ⅣC水平与健康组无差异(P>0.05),HA水平高于健康组(P<0.05)。RA-ILD组患者初治病程、激素应用人数、关节压痛数、DAS28评分、RF高于N-RA-ILD组(P<0.05)。Logistic结果显示初治病程长及RF、ⅣC、HA水平高是RA-ILD发病的危险因素(P<0.05)。ⅣC与年龄、IgG正相关(P<0.05),与激素和/或DMARDS应用负相关(P<0.05)。HA与年龄、CRP、DAS28评分正相关(P<0.05)。结论ⅣC、HA、RF高、初治病程长是RA-ILD发病的危险因素,激素和/或DMARDS可能会延缓RA-ILD发病及进展。Objective To detect the serum levels of laminin(LN),procollagenⅢN-terminal peptide(PⅢNP),typeⅣcollagen(ⅣC)and hyaluronic acid(HA)in rheumatoid arthritis(RA)related interstitial lung disease(RA-ILD),and to explore their correlation.Methods 65 RA-ILD patients,40 non RA-ILD patients and 40 healthy people in our hospital from March 2018 to September 2020 were retrospectively collected.Their LN,PⅢNP,ⅣC and HA were determined by chemiluminescence,and then their correlation with RA-ILD.Results There was no significant difference in the serum level of LN among the three groups(P>0.05).There was no significant difference in the serum level of PⅢNP between the RA-ILD and the non RA-ILD group(P>0.05),but it was higher than the healthy group(P<0.05).Compared with the non RA-ILD group and the healthy group,the serum levels ofⅣC and HA increased more significantly in the RA-ILD group(P<0.001).The serum level of HA group was higher in the non RA-ILD group than in the healthy group(P<0.05),but there was no difference in the serum level ofⅣC between the two groups.The course of disease at the beginning of treatment,the number of people using hormones and joint tender,DAS28 score and RF in the RA-ILD group were higher than those in the non RA-ILD group(P<0.05).The results of multivariate Logistic regression analysis showed that long course of disease at the beginning of treatment,high level ofⅣC,HA and RF were the risk factors for RA-ILD(P<0.05).Serum level ofⅣC had positive correlation with age and IgG(P<0.05),and negative correlation with the treatment of Glucocorticoids and/or DMARDS(P<0.05).Serum level of HA had positive correlation with age,CRP and DAS28 score(P<0.05).Conclusion Long course of disease at the beginning of treatment,high levels of RF,ⅣC and HA may be sensitive markers of RA-ILD,and glucocorticoids and DMARDS may delay the onset and development of RA-ILD.

关 键 词：类风湿性关节炎 间质性肺病 四型胶原 透明质酸 

分 类 号：R593.22[医药卫生—内科学] R563[医药卫生—临床医学]