CCL21及其受体CCR7在ANCA相关性血管炎患者中的临床应用价值  

The clinical application value of CCL21 and its receptor CCR7 in patients with anti-neutrophil cytoplasmic antibody associated vasculitis

作　　者：张铭明[1] 张锐[1] 杨小珂 帅宗文[1] Zhang Mingming;Zhang Rui;Yang Xiaoke;Shuai Zongwen(Dept of Rheumatology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,合肥230022

出　　处：《安徽医科大学学报》2023年第9期1589-1593,共5页Acta Universitatis Medicinalis Anhui

基　　金：定向专项基金项目(编号:ZXF2017003)。

摘　　要：目的探讨趋化因子配体(CCL)21及其受体趋化因子(CCR)7在ANCA相关性血管炎(AASV)患者中的临床应用价值。方法采用ELISA方法检测102例AASV患者以及70例正常对照组外周血中CCL21及其受体CCR7水平,同时测定AASV患者血清中特异性自身抗体、炎症指标以及相关性实验室指标:白介素(IL)-6、肿瘤坏死因子(TNF)-α、尿素氮(BUN)、肌酐(CRE)、补体C3、C4、红细胞沉降率(ESR)、C反应蛋白(CRP)、伯明翰活动性评分(BVAS)进行相关性分析,分析CCL21及其受体CCR7水平与AASV各临床指标相关性以及与病情的活动性。结果AASV患者血清中CCL21及CCR7水平(276.95±57.34);(85.85±18.77)pg/ml明显高于正常对照组(179.91±19.45);(54.83±18.18)pg/ml;且靶抗原髓过氧化物酶(MPO)阳性患者CCL21及CCR7水平(294.94±58.15);(90.64±18.38)pg/ml高于靶抗原MPO阴性患者(244.35±46.76);(78.37±13.44)pg/ml(P<0.05);CCL21及CCR7水平均与AASV患者BUN、CRE、MPO、CRP、TNF-α、IL-6、BVAS正相关,且AASV患者血清中CCL21及CCR7水平之间呈正相关。受试者工作曲线(ROC)结果发现,血清CCL21及CCR7水平对AASV活动性具有预测价值。结论AASV患者尤其在MPO阳性患者血清中CCL21及CCR7水平呈高表达,其表达水平与患者肾功能以及相关炎症指标具有明显相关性,血清CCL21及CCR7是AASV患者病情BVAS的影响因素,对诊断AASV及预测疾病活动性具有重要的临床价值。Objective To investigate the clinical application value of chemokine ligand(CCL)21 and its receptor chemokine(CCR)7 in patients with anti-neutrophil cytoplasmic antibody associated vasculitis.Methods The serum levels of CCL21 and its receptor CCR7 were measured by ELISA methods in 102 patients with AASV and 70 healthy controls.At the same time,the correlation among the CCL21,CCR7,MPO,PR3 and general laboratory index of TNF-α,IL-6,BUN,CRE,C3,C4 ESR,CRP,BVAS in AASV patients was analyzed.Results The serum levels of the CCL21 and CCR7 were significantly higher in AASV patients than that in healthy controls[(276.95±57.34)vs(179.91±19.45);(85.85±18.77)vs(54.83±18.18)pg/ml](P<0.05).The serum levels of the CCL21 and CCR7 in MPO positive patients were higher than those in MPO negative patients[(294.94±58.15)vs(244.35±46.76);(90.64±18.38)vs(78.37±13.44)pg/ml](P<0.05).Moreover,The levels of the CCL21 and CCR7 were similar to those of TNF-α,IL-6,CRE,BUN,CRP,BVAS and MPO in AASV patients,the levels of the CCL21 and CCR7 in AASV patients were positively correlated.The serum levels of the CCL21 and CCR7 were found to be predictive of AASV activity with ROC.Conclusion The serum level of CCL21 and CCR7 in AASV patients increased significantly,especially in MPO positive patients,and related to patients with renal function index and related inflammation index.Serum CCL21 and CCR7 are the influencing factors of BVAS in AASV patients,and have important significance in the diagnosis and judgment of AASV disease.

关 键 词：抗中性粒细胞抗体 血管炎 核周型 胞浆型 趋化因子 

分 类 号：R593.27[医药卫生—内科学]