CAJ | 학술논문

目的分析类风湿关节炎(RA)合并肺间质病变(ILD)患者血清白细胞介素(IL)-33及其受体人基质裂解素2(ST2)的表达情况及与肺功能等实验室指标的相关性,为其早期诊断提供依据.方法收集2012年3月至2013年3月在我科初诊为RA患者245例,分为RA-ILD组58例与单纯RA组187例,观察各组肺功能等相关实验室指标,另收集我院体检中心健康体检者60名为健康对照组.采用酶联免疫吸附试验(ELISA)法测定以上各组的血清IL-33及ST2浓度水平.组间比较采用两样本t检验；多组间比较采用多个样本均数比较的方差分析；IL-33浓度及相关变量间比较采用Pearson相关分析.结果 RA患者ILD发生率为23.7％(58/245).与健康对照组[(85±38) pg/ml]相比,RA[(433±42) pg/ml]及RA-ILD [(746±43) pg/ml]患者中血清IL-33水平显著增高,差异有统计学意义(P＜0.01)；且与RA组患者相比,RA-ILD组患者血清IL-33及ST2水平升高更为明显(P＜0.01).RA-ILD组患者肺活量占预计值百分比(VC％)、用力肺活量占预计值百分比(FVC％)、最大呼气中段流量占预计值百分比(MMF％)和一氧化碳弥散量(DLCO)多项肺功能指标均较RA组患者明显降低,差异有统计学意义(P＜0.01).IL-33浓度与各实验室指标相关性比较:IL-33浓度与类风湿因子呈正相关(r=0.82,P＜0.01),且与抗环瓜氨酸多肽抗体(ACPA)滴度呈正相关(r=0.55,P＜0.01),而其与DLCO呈负相关(r=-0.80,P＜0.01).结论 IL-33参与RA的发病过程,且可能与RA-ILD的发病相关.
목적 분석류풍습관절염(RA)합병폐간질병변(ILD)환자혈청백세포개소(IL)-33급기수체인기질렬해소2(ST2)적표체정황급여폐공능등실험실지표적상관성,위기조기진단제공의거.방법 수집2012년3월지2013년3월재아과초진위RA환자245례,분위RA-ILD조58례여단순RA조187례,관찰각조폐공능등상관실험실지표,령수집아원체검중심건강체검자60명위건강대조조.채용매련면역흡부시험(ELISA)법측정이상각조적혈청IL-33급ST2농도수평.조간비교채용량양본t검험；다조간비교채용다개양본균수비교적방차분석；IL-33농도급상관변량간비교채용Pearson상관분석.결과 RA환자ILD발생솔위23.7％(58/245).여건강대조조[(85±38) pg/ml]상비,RA[(433±42) pg/ml]급RA-ILD [(746±43) pg/ml]환자중혈청IL-33수평현저증고,차이유통계학의의(P＜0.01)；차여RA조환자상비,RA-ILD조환자혈청IL-33급ST2수평승고경위명현(P＜0.01).RA-ILD조환자폐활량점예계치백분비(VC％)、용력폐활량점예계치백분비(FVC％)、최대호기중단류량점예계치백분비(MMF％)화일양화탄미산량(DLCO)다항폐공능지표균교RA조환자명현강저,차이유통계학의의(P＜0.01).IL-33농도여각실험실지표상관성비교:IL-33농도여류풍습인자정정상관(r=0.82,P＜0.01),차여항배과안산다태항체(ACPA)적도정정상관(r=0.55,P＜0.01),이기여DLCO정부상관(r=-0.80,P＜0.01).결론 IL-33삼여RA적발병과정,차가능여RA-ILD적발병상관.
Objective To study the association between serum interleukin-33 (IL-33) level and human stromelysin-2 (ST2) level in patients with rheumatoid arthritis (RA) associated with interstitial lung disease (RA-ILD) and its correlation with lung function and other laboratory parameters.Methods Two hundred and forty-five newly diagnosed RA patients during March 2012 to March 2013 in the in-patient and out-patient clinic of the First Affiliated Hospital of Liaoning Medical College were enrolled into this study.Patients were further divided into RA group (n=187) and RA-ILD group (n=58).Sixty subjects who came to the hospital for routine health check-up was composed of the normal control group.The clinical data of the two groups and controls were collected and their serum IL-33 and ST2 concentrations were measured.The t test was used to compare the difference between the two groups.Multiple variance analysis was used to com-pare the difference between groups.Pearson's correlation analysis was applied to explore the relationship between IL-33 concentrations and related variables.Results ① This study showed that the prevalence of RA associated interstitial lung disease was 23.7％(58/245).② The concentration of IL-33 [(746±43) pg/ml] and ST2 [(3413±169)pg/ml] of the RA-ILD group was significantly higher than that of the RA group [(433±42) pg/ml,(1500±147) pg/ml] (P＜0.01).③The vital capacity (VC％),forced vital capac-ity (FVC％),maximal midexpiratary flow curve (MMF％) and carbon monoxide diffusing capacity (DLCO) of the RA-ILD group were significantly lower than those of the RA group.④ The serum level of IL-33 was negatively correlated with that of RF and ACPA (IL-33 and RF,r=0.82,P＜0.01; IL-33 and ACPA,r=0.55,P＜0.01).Serum level of IL-33 was negaitively correlated with DLCO (r=-0.80,P＜0.01).Conclusion IL-33 participates in the pathogenesis of RA; and may be involved in the pathogenesis of RA-ILD.