摘要
目的:检测多发性肌炎/皮肌炎(polymyosits/dermatomyosits,PM/DM)患者血清中单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)的水平,分析其在PM/DM中的临床意义。方法:采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)方法测定100例PM/DM患者、20例肺部感染患者以及42名健康对照者血清中MCP-1水平,分析PM/DM患者临床表现及预后与血清MCP-1水平的相关性。结果:血清MCP-1浓度在合并肺间质疾病(interstitial lung disease,ILD)的PM/DM组、未合并ILD的PM/DM组、肺部感染组和正常对照组的平均值分别是(1 869±1 590)ng/L、(1 349±1 303)ng/L、(493±255)ng/L和(256±144)ng/L。PM/DM患者血清MCP-1水平高于肺部感染组及正常对照组(P均<0.001),合并ILD的PM/DM组血清MCP-1水平较未合并ILD的PM/DM组、肺部感染组和正常对照组均显著升高(P均<0.01)。血清MCP-1的升高与肺间质病变存在显著关联性(χ2=9.6,P<0.01)。MCP-1诊断PM/DM合并ILD的敏感性为60.7%、特异性为68.2%。MCP-1升高组中,发热、关节炎、一氧化碳弥散量(%DLCO)下降的发生率以及血红细胞沉降率、C反应蛋白、血清铁蛋白水平均较MCP-1正常组明显升高(P均<0.05)。相关性分析显示,PM/DM患者血清MCP-1水平与血清铁蛋白呈显著正相关(r=0.488,P<0.001)。结论:MCP-1在PM/DM患者血清中表达增高,并与合并ILD密切相关,可用于鉴别肺部感染和肺间质病变,具有重要临床意义。
Objective：To analyze the correlated clinical significance by testing the serum monocyte chemoattractant protein-1（MCP-1） levels of patients with polymyositis/dermatomyositis（PM/DM）.Methods： The sera from 100 adult PM/DM patients,20 patients with pulmonary infection and 42 healthy controls were selected.The serum MCP-1 concentrations were detected by enzyme-linked immunosorbent assay（ELISA）.The correlations between serum MCP-1 levels and clinical features or laboratory examinations of PM/DM patients were investigated.Results： The serum levels of MCP-1 were（1 869±1 590） ng/L,（1 349±1 303） ng/L,（493±255） ng/L and（256±144） ng/L in PM/DM patients with interstitial lung disease（ILD） and without ILD,patients with infectious lung disease and healthy controls,respectively.Serum MCP-1 levels in the PM/DM patients with ILD were significantly higher than those of the PM/DM patients without ILD,patients with infectious lung disease and healthy controls（all P values0.01）.Significant correlations were found between the elevated levels of serum MCP-1 and the presence of ILD in the patients with PM/DM（χ2=9.6,P0.01）.The sensitivity and specificity of serum abnormal MCP-1 levels for ILD in the patients with PM/DM were 60.7% and 68.2%,respectively.The incidence of fever,arthritis,decreased %DLCO,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP） and serum ferritin were significantly higher in the MCP-1 raised group than in the MCP-1 normal group（all P values0.005）.Additionally,Spearman rank correlation analysis showed that serum MCP-1 levels were positively correlated with serum ferritin in peripheral blood in the patients with PM/DM.Conclusion： The levels of serum MCP-1 are significantly elevated in PM/DM and it is significantly associated with ILD complication,and may contribute to the early differentiation of ILD from lung infectious disease.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2012年第2期204-208,共5页
Journal of Peking University:Health Sciences
基金
首都临床特色应用研究项目(Z111107058811084)资助~~
