中华临床免疫和变态反应杂志
中華臨床免疫和變態反應雜誌
중화림상면역화변태반응잡지
CHINESE JOURNAL OF ALLERGY & CLINICAL IMMUNOLOGY
2014年
2期
101-107
,共7页
张昊泽%李萍%徐东%侯勇%王迁%李梦涛%李永哲%曾小峰%张奉春
張昊澤%李萍%徐東%侯勇%王遷%李夢濤%李永哲%曾小峰%張奉春
장호택%리평%서동%후용%왕천%리몽도%리영철%증소봉%장봉춘
IgG亚类%系统性硬化症%IgG4相关性疾病%免疫散射比浊法
IgG亞類%繫統性硬化癥%IgG4相關性疾病%免疫散射比濁法
IgG아류%계통성경화증%IgG4상관성질병%면역산사비탁법
IgG-subclass%systemic-sclerosis%IgG4-related-diseases%immuno-scatter-turbidmetry
目的:探讨血清 IgG 亚类与系统性硬化症(systemic sclerosis,SSc)的关系,分析 IgG 亚类在 SSc 中的分布特点以及在 SSc 中血清 IgG4是否显著升高。方法利用免疫散射比浊法检测102例 SSc 患者及40例健康对照者(healthy controls, HC)血清 IgG1-4浓度,比较分析 SSc 组血清 IgG 亚类水平与 HC 组有无差异,并结合 SSc 患者临床资料,分析具有不同临床特征的 SSc 患者 IgG 亚类分布特点及其相关性。结果与 HC 组相比,SSc 组血清 IgG1(IgG1/IgG)[IgG1:(8085.00±1565.68)mg/L vs.(9236.67±3258.62)mg/L;IgG1/IgG:(56.83±8.16)% vs.(63.66±9.68)%]、IgG3(IgG3/IgG)[IgG3:(394.60±232.79)mg/L vs.(703.69±509.57)mg/L;IgG3/IgG:(2.72±1.46)% vs.(4.74±2.92)%]水平显著升高,而 IgG2(IgG2/IgG)[IgG2:(5406.25±2150.77)mg/L vs.(4117.56±1668.37)mg/L;IgG2/IgG:(36.57±7.84)% vs.(28.46±8.47)%]、IgG4(IgG4/IgG)[IgG4:485.50(53.62,1454.00)mg/L vs.289.00(91.26,1529.50)mg/L;IgG4/IgG:3.20(0.52,10.17)% vs.2.04(0.65,8.83)%]水平显著降低;IgG 正常的 SSc 组患者与 HC 组比较,其血清 IgG3(IgG3/IgG)[IgG3:(617.68±435.42)mg/L vs.(368.24±220.54)mg/L;IgG3/IgG:(4.69±2.90)% vs.(2.73±1.50)%]、IgG1/IgG [IgG1/IgG:(63.16±9.50)% vs.(58.41±6.72)%]水平显著升高,IgG2(IgG2/IgG)[IgG2:(3745.14±1489.10) mg/L vs.(4677.58±1240.16)mg/L;IgG2/IgG:(29.06±8.45)% vs.(34.73±5.66)%]、IgG4(IgG4/IgG)[IgG4:250.00(91.01,1365.50)mg/L vs.511.00(50.71,1644.00)mg/L;IgG4/IgG:2.03(0.65,8.73)% vs.3.54(0.47,11.11)%]水平显著降低,差异均有统计学意义(均 P <0.05)。SSc 组中 IgG4>1350 mg/L 者占6.86%,HC 组中>1350 mg/L 者占5.00%,两组比较差异无统计学意义(P =0.978)。与抗 Scl-70阴性 SSc 患者比较,抗 Scl-70阳性 SSc 患者血清 IgG2(IgG2/IgG)[IgG2:3460.00(1346.95,8352.00)mg/L vs.4280.00(1568.00,7612.00)mg/L;IgG2/IgG:25.44(8.09,46.94)%vs.30.94(15.39,41.92)%]水平显著升高,血清 IgG1/IgG [68.26(45.95,88.07)% vs.62.33(48.04,76.41)%]水平显著下降;合并肺动脉高压(pulmonary arterial hypertension,PAH)的 SSc 患者血清 IgG1(IgG1/IgG)[IgG1:7850.00(5250.00,17300.00)mg/L vs.9170.00(7461.00,16470.00)mg/L;IgG1/IgG:64.04(46.64,74.89)% vs.67.45(51.25,84.91)%]水平显著高于未合并 PAH 者,血清 IgG2/IgG [28.72(17.19,42.89)% vs.24.77(10.29,42.39)], IgG4/IgG [2.21(0.65,8.80)% vs.1.94(0.42,7.40)%]水平显著低于未合并 PAH 者,差异均有统计学意义(P <0.05)。SSc 患者从出现雷诺现象到 SSc 发病的时间与血清 IgG2呈现低度相关(r =0.353,P =0.001)。结论血清 IgG 亚类在 SSc 患者中的分布明显不同于健康人群,即使是 IgG 正常的 SSc 患者其 IgG 亚类分布也不同于健康人群,SSc 患者中血清IgG4(IgG4/IgG)水平明显低于健康人群,血清 IgG 亚类在具有不同临床特点的 SSc 患者中的分布存在显著差异。
目的:探討血清 IgG 亞類與繫統性硬化癥(systemic sclerosis,SSc)的關繫,分析 IgG 亞類在 SSc 中的分佈特點以及在 SSc 中血清 IgG4是否顯著升高。方法利用免疫散射比濁法檢測102例 SSc 患者及40例健康對照者(healthy controls, HC)血清 IgG1-4濃度,比較分析 SSc 組血清 IgG 亞類水平與 HC 組有無差異,併結閤 SSc 患者臨床資料,分析具有不同臨床特徵的 SSc 患者 IgG 亞類分佈特點及其相關性。結果與 HC 組相比,SSc 組血清 IgG1(IgG1/IgG)[IgG1:(8085.00±1565.68)mg/L vs.(9236.67±3258.62)mg/L;IgG1/IgG:(56.83±8.16)% vs.(63.66±9.68)%]、IgG3(IgG3/IgG)[IgG3:(394.60±232.79)mg/L vs.(703.69±509.57)mg/L;IgG3/IgG:(2.72±1.46)% vs.(4.74±2.92)%]水平顯著升高,而 IgG2(IgG2/IgG)[IgG2:(5406.25±2150.77)mg/L vs.(4117.56±1668.37)mg/L;IgG2/IgG:(36.57±7.84)% vs.(28.46±8.47)%]、IgG4(IgG4/IgG)[IgG4:485.50(53.62,1454.00)mg/L vs.289.00(91.26,1529.50)mg/L;IgG4/IgG:3.20(0.52,10.17)% vs.2.04(0.65,8.83)%]水平顯著降低;IgG 正常的 SSc 組患者與 HC 組比較,其血清 IgG3(IgG3/IgG)[IgG3:(617.68±435.42)mg/L vs.(368.24±220.54)mg/L;IgG3/IgG:(4.69±2.90)% vs.(2.73±1.50)%]、IgG1/IgG [IgG1/IgG:(63.16±9.50)% vs.(58.41±6.72)%]水平顯著升高,IgG2(IgG2/IgG)[IgG2:(3745.14±1489.10) mg/L vs.(4677.58±1240.16)mg/L;IgG2/IgG:(29.06±8.45)% vs.(34.73±5.66)%]、IgG4(IgG4/IgG)[IgG4:250.00(91.01,1365.50)mg/L vs.511.00(50.71,1644.00)mg/L;IgG4/IgG:2.03(0.65,8.73)% vs.3.54(0.47,11.11)%]水平顯著降低,差異均有統計學意義(均 P <0.05)。SSc 組中 IgG4>1350 mg/L 者佔6.86%,HC 組中>1350 mg/L 者佔5.00%,兩組比較差異無統計學意義(P =0.978)。與抗 Scl-70陰性 SSc 患者比較,抗 Scl-70暘性 SSc 患者血清 IgG2(IgG2/IgG)[IgG2:3460.00(1346.95,8352.00)mg/L vs.4280.00(1568.00,7612.00)mg/L;IgG2/IgG:25.44(8.09,46.94)%vs.30.94(15.39,41.92)%]水平顯著升高,血清 IgG1/IgG [68.26(45.95,88.07)% vs.62.33(48.04,76.41)%]水平顯著下降;閤併肺動脈高壓(pulmonary arterial hypertension,PAH)的 SSc 患者血清 IgG1(IgG1/IgG)[IgG1:7850.00(5250.00,17300.00)mg/L vs.9170.00(7461.00,16470.00)mg/L;IgG1/IgG:64.04(46.64,74.89)% vs.67.45(51.25,84.91)%]水平顯著高于未閤併 PAH 者,血清 IgG2/IgG [28.72(17.19,42.89)% vs.24.77(10.29,42.39)], IgG4/IgG [2.21(0.65,8.80)% vs.1.94(0.42,7.40)%]水平顯著低于未閤併 PAH 者,差異均有統計學意義(P <0.05)。SSc 患者從齣現雷諾現象到 SSc 髮病的時間與血清 IgG2呈現低度相關(r =0.353,P =0.001)。結論血清 IgG 亞類在 SSc 患者中的分佈明顯不同于健康人群,即使是 IgG 正常的 SSc 患者其 IgG 亞類分佈也不同于健康人群,SSc 患者中血清IgG4(IgG4/IgG)水平明顯低于健康人群,血清 IgG 亞類在具有不同臨床特點的 SSc 患者中的分佈存在顯著差異。
목적:탐토혈청 IgG 아류여계통성경화증(systemic sclerosis,SSc)적관계,분석 IgG 아류재 SSc 중적분포특점이급재 SSc 중혈청 IgG4시부현저승고。방법이용면역산사비탁법검측102례 SSc 환자급40례건강대조자(healthy controls, HC)혈청 IgG1-4농도,비교분석 SSc 조혈청 IgG 아류수평여 HC 조유무차이,병결합 SSc 환자림상자료,분석구유불동림상특정적 SSc 환자 IgG 아류분포특점급기상관성。결과여 HC 조상비,SSc 조혈청 IgG1(IgG1/IgG)[IgG1:(8085.00±1565.68)mg/L vs.(9236.67±3258.62)mg/L;IgG1/IgG:(56.83±8.16)% vs.(63.66±9.68)%]、IgG3(IgG3/IgG)[IgG3:(394.60±232.79)mg/L vs.(703.69±509.57)mg/L;IgG3/IgG:(2.72±1.46)% vs.(4.74±2.92)%]수평현저승고,이 IgG2(IgG2/IgG)[IgG2:(5406.25±2150.77)mg/L vs.(4117.56±1668.37)mg/L;IgG2/IgG:(36.57±7.84)% vs.(28.46±8.47)%]、IgG4(IgG4/IgG)[IgG4:485.50(53.62,1454.00)mg/L vs.289.00(91.26,1529.50)mg/L;IgG4/IgG:3.20(0.52,10.17)% vs.2.04(0.65,8.83)%]수평현저강저;IgG 정상적 SSc 조환자여 HC 조비교,기혈청 IgG3(IgG3/IgG)[IgG3:(617.68±435.42)mg/L vs.(368.24±220.54)mg/L;IgG3/IgG:(4.69±2.90)% vs.(2.73±1.50)%]、IgG1/IgG [IgG1/IgG:(63.16±9.50)% vs.(58.41±6.72)%]수평현저승고,IgG2(IgG2/IgG)[IgG2:(3745.14±1489.10) mg/L vs.(4677.58±1240.16)mg/L;IgG2/IgG:(29.06±8.45)% vs.(34.73±5.66)%]、IgG4(IgG4/IgG)[IgG4:250.00(91.01,1365.50)mg/L vs.511.00(50.71,1644.00)mg/L;IgG4/IgG:2.03(0.65,8.73)% vs.3.54(0.47,11.11)%]수평현저강저,차이균유통계학의의(균 P <0.05)。SSc 조중 IgG4>1350 mg/L 자점6.86%,HC 조중>1350 mg/L 자점5.00%,량조비교차이무통계학의의(P =0.978)。여항 Scl-70음성 SSc 환자비교,항 Scl-70양성 SSc 환자혈청 IgG2(IgG2/IgG)[IgG2:3460.00(1346.95,8352.00)mg/L vs.4280.00(1568.00,7612.00)mg/L;IgG2/IgG:25.44(8.09,46.94)%vs.30.94(15.39,41.92)%]수평현저승고,혈청 IgG1/IgG [68.26(45.95,88.07)% vs.62.33(48.04,76.41)%]수평현저하강;합병폐동맥고압(pulmonary arterial hypertension,PAH)적 SSc 환자혈청 IgG1(IgG1/IgG)[IgG1:7850.00(5250.00,17300.00)mg/L vs.9170.00(7461.00,16470.00)mg/L;IgG1/IgG:64.04(46.64,74.89)% vs.67.45(51.25,84.91)%]수평현저고우미합병 PAH 자,혈청 IgG2/IgG [28.72(17.19,42.89)% vs.24.77(10.29,42.39)], IgG4/IgG [2.21(0.65,8.80)% vs.1.94(0.42,7.40)%]수평현저저우미합병 PAH 자,차이균유통계학의의(P <0.05)。SSc 환자종출현뢰낙현상도 SSc 발병적시간여혈청 IgG2정현저도상관(r =0.353,P =0.001)。결론혈청 IgG 아류재 SSc 환자중적분포명현불동우건강인군,즉사시 IgG 정상적 SSc 환자기 IgG 아류분포야불동우건강인군,SSc 환자중혈청IgG4(IgG4/IgG)수평명현저우건강인군,혈청 IgG 아류재구유불동림상특점적 SSc 환자중적분포존재현저차이。
Objective To investigate the relationship between serum IgG subclass levels and the characteristic serum IgG subclass distribution in systemic sclerosis(SSc),and to explore whether IgG4 was significantly increaseed in SSc patients.Methods Serum IgG subclass levels from 1 02 SSc patients and 40 healthy subjects as the control group(HC)were determined by immuno-scatter turbidmetry.The differences of IgG subclass distribution between SSc group and HC group were analyzed. Combined with the clinical information of SSc patients,the differences of serum IgG subclass distribution in SSc patients with different characteristics were analyzed.Results Compared with HC group,the serum IgG1 (IgG1 /IgG)[IgG1 :(8 085.00 ±1 565.68)mg/L vs.(9 236.67 ±3 258.62)mg/L;IgG1 /IgG:(56.83 ±8.1 6)% vs.(63.66 ±9.68)%],IgG3(IgG3/IgG)[IgG3:(394.60 ±232.79)mg/L vs.(703.69 ±509.57)mg/L;IgG3/IgG:(2.72 ±1 .46)% vs.(4.74 ±2.92)%]levels in SSc group were significantly higher,while IgG2 (IgG2/IgG) [IgG2:(5 406.25 ±2 1 50.77 )mg/L vs.(4 1 1 7.56 ±1 668.37 )mg/L;IgG2/IgG:(36.57 ±7.84)% vs.(28.46 ±8.47)%],IgG4(IgG4/IgG)[IgG4:485.50 (53.62,1 454.00)mg/L vs.289.00 (91 .26,1 529.50)mg/L;IgG4/IgG:3.20 (0.52,1 0.1 7)% vs.2.04 (0.65,8.83)%] were significantly lower (P <0.05).The serum IgG3(IgG3/IgG)[IgG3:(61 7.68 ±435.42)mg/L vs. (368.24 ±220.54)mg/L;IgG3/IgG:(4.69 ±2.90)% vs.(2.73 ±1 .50)%],IgG1 /IgG [IgG1 /IgG:(63.1 6 ±9.50)% vs.(58.41 ±6.72 )%]levels in SSc patients with normal IgG were significantly higher,while IgG2(IgG2/IgG)[IgG2:(3745.1 4 ±1 489.1 0)mg/L vs.(4 677.58 ±1 240.1 6)mg/L;IgG2/IgG:(29.06 ±8.45 )% vs.(34.73 ±5.66 )%],IgG4 (IgG4/IgG) [IgG4:250.00 (91 .01 , 1 365.50)mg/L vs.51 1 .00 (50.71 ,1 644.00)mg/L;IgG4/IgG:2.03 (0.65,8.73 )% vs.3.54 (0.47,1 1 .1 1 )%]were significantly lower than those in HC subjects (P <0.05).Serum IgG4 level was higher than 1 350 mg/L in 6.86% SSc patients and 5.0% HC subjects.There wasn’t significant difference in IgG4 level between the two groups (P =0.978).In the SSc subgroups,anti-Scl-70(+)patients had significantly higher serum IgG2(IgG2/IgG)[IgG2:3460.00 (1 346.95,8 352.00)mg/L vs.4 280.00 (1 568.00,7 61 2.00)mg/L;IgG2/IgG:25.44 (8.09,46.94)% vs.30.94 (1 5.39,41 .92)%] level than anti-Scl-70 (-)patients,while anti-Scl-70 (+)SSc patients had significantly lower serum IgG1 /IgG [68.26 (45.95,88.07)% vs.62.33 (48.04,76.41 )%]level than anti-Scl-70(-)patients (P <0.05 ). The SSc patients who complicated with pulmonary arterial hypertension (PAH ) had significantly higher serum IgG1 (IgG1 /IgG)[IgG1 :7850.00 (5 250.00,1 7 300.00)mg/L vs.9 1 70.00 (7 461 .00,1 6 470.00)mg/L;IgG1 /IgG:64.04 (46.64,74.89)% vs.67.45 (51 .25,84.91 )%] level than the patients without PAH,while the SSc patients with PAH had significantly lower serum IgG2/IgG [28.72 (1 7.1 9,42.89)% vs.24.77 (1 0.29,42.39)]and IgG4/IgG [2.21 (0.65,8.80)%vs.1 .94 (0.42,7.40)%]levels than patients without PAH (P <0.05).Positive correlation was found between the duration of Raynaud’s phenomenon to SSc and the serum IgG2 level (r =0.353,P =0.001 ). Conclusions There is significant difference in serum IgG subclass distribution between SSc group and HC group,even in SSc patients with normal IgG level.We have found that serum IgG4(IgG4/IgG)level in the SSc group is significantly lower than HC group.There is difference in IgG subclass distribution in SSc patients with different clinical characteristics.