类风湿因子在原发性干燥综合征伴肺间质疾病中的诊断价值  

Diagnostic value of rheumatoid factor in primary Sjogren′s syndrome with interstitial pulmonary disease

作　　者：万绍恒[1] 李中燕[2] 王家驷[1] WAN Shaoheng;LI Zhongyan;WANG Jiasi(Department of Clinical Laboratory,Dazhou Central Hospital,Dazhou,Sichuan 635000,China;Department of Respiratory Medicine,Dazhou Central Hospital,Dazhou,Sichuan 635000,China)

机构地区：[1]四川省达州市中心医院检验科,四川达州635000 [2]四川省达州市中心医院呼吸内科,四川达州635000

出　　处：《检验医学与临床》2022年第13期1754-1756,1760,共4页Laboratory Medicine and Clinic

基　　金：四川省卫生和计划生育委员会科研项目(17PJ028)。

摘　　要：目的探讨原发性干燥综合征(pSS)伴肺间质疾病(ILD)的影响因素及类风湿因子(RF)的诊断价值。方法收集2014年1月至2020年11月在该院住院治疗的356例pSS患者临床资料,选取pSS伴ILD患者65例作为pSS-ILD组,pSS不伴ILD患者291例作为pSS-no ILD组。采用单因素和多因素分析筛选可疑影响因素,再用倾向性评分匹配法平衡RF的混杂因素,然后绘制受试者工作特征(ROC)曲线并计算RF的各项诊断指标。结果pSS-ILD组患者年龄、免疫球蛋白M、C反应蛋白(CRP)、RF水平及抗核抗体(ANA)阳性、抗SSA抗体阳性、肾脏受累比例均高于pSS-no ILD组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,RF水平升高、CRP水平升高及年龄增长是pSS患者发生ILD的危险因素(OR=1.178、1.081、1.120,95%CI:1.042~1.330、1.011~1.155、1.022~1.228,P<0.05);RF对pSS-ILD诊断的ROC曲线下面积(AUC)为0.81(95%CI:0.73~0.89),当RF的cut off值为33.20 U/mL时,其对pSS-ILD诊断的灵敏度、特异度、约登指数分别为71.00%、96.00%、0.67。结论CRP水平升高、RF水平升高及年龄增长是pSS患者发生ILD的危险因素,其中RF可作为辅助诊断pSS-ILD的良好指标。Objective To investigate the influencing factors of primary Sjogren′s syndrome(pSS)with interstitial pulmonary disease(ILD)and the diagnostic value of rheumatoid factor(RF).Methods The clinical data of 356 patients with pSS who were hospitalized in this hospital from January 2014 to November 2020 were collected,65 patients with pSS and ILD were selected as the pSS-ILD group,and 291 patients with pSS without ILD were selected as the pSS-no ILD group.Univariate and multivariate analysis was used to screen suspicious influencing factors,and propensity score matching was used to balance the confounding factors of RF.Then,receiver operating characteristic(ROC)curve was drawn and various diagnostic indicators of RF were calculated.Results The age,immunoglobulin M,C-reactive protein(CRP),RF levels and the proportion of positive antinuclear antibody(ANA),positive anti-SSA antibody and renal involvement in the pSS-ILD group were higher than those in the pSS-no ILD group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that increased RF level,increased CRP level,and increased age were the risk factors for ILD in pSS patients(OR=1.178,1.081,1.120,95%CI:1.042—1.330,1.011—1.155,1.022—1.228,P<0.05).The area under the ROC curve(AUC)of RF for the diagnosis of pSS-ILD was 0.81(95%CI:0.73—0.89).When the cut off value of RF was 33.20 U/mL,the sensitivity,specificity and Youden index for the diagnosis of pSS-ILD were 71.00%,96.00%,0.67 respectively.Conclusion The increase of CRP level,RF level and age are the risk factors for the occurrence of ILD in pSS patients.RF could be used as a good index to assist in the diagnosis of pSS-ILD.

关 键 词：类风湿因子 原发性干燥综合征 肺间质疾病 

分 类 号：R392[医药卫生—免疫学]