B细胞刺激因子在特发性炎性肌病相关肺间质病变的临床意义  

Clinical significance of B cell activating factor of the TNF family in idiopathic inflammatory myopathy with interstitial lung disease

作　　者：徐晓晓 黄敏慧 谢晓韵[1] 李懿莎[1] XU Xiao-xiao;HUANG Min-hui;XIE Xiao-yun;LI Yi-sha(Department of Rheumatology&Immunology,Xiangya Hospital,Central South University,National Clinical Research Center for Geriatric Diseases,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院风湿免疫科,国家老年疾病临床医学研究中心,长沙410008

出　　处：《中华临床免疫和变态反应杂志》2023年第4期335-341,共7页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的探究B细胞刺激因子(BAFF)在特发性炎性肌病(IIM)相关肺间质病变(ILD)中的临床意义。方法纳入122例IIM患者,其中86例并发ILD,按性别、年龄匹配40例正常人作为对照,采用酶联免疫吸附试验检测BAFF,分析其临床意义。结果与non-ILD组相比,IIM-ILD组BAFF水平显著升高[2.19(1.07~4.54)ng mL vs.1.14(0.61~2.30)ng mL,P=0.005],是IIM-ILD的独立危险因素。抗MDA5抗体及抗合成酶抗体(ASA)阳性的IIM患者BAFF水平显著高于双阴性患者(P<0.05)。BAFF>3.74 ng mL时,对于诊断IIM-ILD的敏感性为36.0%,特异性为97.2%(AUC=0.681,P=0.002);联合KL-6时,对于诊断IIM-ILD的敏感性为82.6%,特异性为80.6%(AUC=0.868,P<0.001)。BAFF与铁蛋白呈正相关(r=0.368,P<0.001),与KL-6、肺部HRCT评分、肺功能无明显相关性。结论BAFF在IIM-ILD患者中显著升高,可作为IIM人群合并ILD的生物标志物。Objective To investigate the clinical significance of B cell activating factor of the TNF family(BAFF)in idiopathic inflammatory myopathy(IIM)associated interstitial lung disease(ILD).Methods A total of 122 IIM patients were enrolled in this study,including 86 patients with ILD.In addition,40 healthy people were matched by sex and age as controls.The levels of BAFF were detected by enzyme-linked immunosorbent assay and its clinical significance was analyzed.Results The levels of BAFF were higher in patients with IIM-ILD compared with the non-ILD group[2.19(1.07~4.54)ng mL vs.1.14(0.61~2.30)ng mL,P=0.005],which was an independent risk factor for IIM-ILD.The levels of BAFF in IIM patients with anti-MDA5 antibody and anti-aminoacyl-tRNA synthetase antibodies(ASA)positive were significantly higher than those in double-negative patients(P<0.05).The sensitivity was 36.0%and specificity was 97.2%(AUC=0.681,P=0.002)for the diagnosis of IIM-ILD when BAFF levels were higher than 3.74 ng mL,when combined with KL-6,the sensitivity and specificity of IIM-ILD were 82.6%and 80.6%respectively(AUC=0.868,P<0.001).The level of BAFF was positively correlated with ferritin(r=0.368,P<0.001)and had no significant correlation with KL-6,lung HRCT score,or lung function.Conclusion The level of BAFF is significantly increased in IIM-ILD patients and can be used as a biomarker for ILD in IIM populations.

关 键 词：特发性炎性肌病 肺间质病变 B细胞刺激因子 KL-6 肌炎特异性抗体 

分 类 号：R593.2[医药卫生—内科学] R563[医药卫生—临床医学]