CAJ | 학술논문

目的检测多发性肌炎/皮肌炎患者血清可溶性人类白细胞抗原-G (sHLA-G)水平,并分析其与多发性肌炎/皮肌炎各临床特征及治疗和预后的关系,探讨血清sHLA-G在多发性肌炎/皮肌炎发病机制中的可能作用.方法利用酶联免疫吸附试验(ELISA)方法测定96例多发性肌炎/皮肌炎患者(其中多发性肌炎26例,皮肌炎70例)和35名健康体检者血清sHLA-G水平,分析血清sHLA-G与多发性肌炎/皮肌炎患者临床特征、实验室指标及治疗、预后的关系.结果血清sHLA-G水平在多发性肌炎/皮肌炎患者[(44±70) U/ml]明显高于健康对照者[(4±5)U/ml,P＜0.01)].皮肌炎患者组血清sHLA-G水平[(54±81) U/ml]明显高于多发性肌炎患者组[(27±41) U/ml,P=0.004].血清sHLA-G升高组多发性肌炎/皮肌炎患者中吞咽困难的发生率较sHLA-G正常组明显升高(P=0.001).sHLA-G水平与CD3+T细胞和CD4+T细胞水平均呈负相关(r=-0.233,P=0.047；r=-0.287,P=0.015),与补体C3水平呈正相关(r=0.284,P=0.021).初治组患者血清sHLA-G水平[(77±99) U/ml]显著高于经治组[(34±52) U/ml,P=0.021].但血清sHLA-G水平与疾病活动度无明显相关,糖皮质激素及免疫抑制剂治疗对血清sHLA-G水平也无明显影响.结论血清sHLA-G水平在多发性肌炎/皮肌炎患者中明显升高,并且与外周血CD3+和CD4+T细胞数呈负相关,临床上与吞咽困难的发生相关,提示sHLA-G可能在多发性肌炎/皮肌炎病理过程中发挥一定作用.
목적 검측다발성기염/피기염환자혈청가용성인류백세포항원-G (sHLA-G)수평,병분석기여다발성기염/피기염각림상특정급치료화예후적관계,탐토혈청sHLA-G재다발성기염/피기염발병궤제중적가능작용.방법 이용매련면역흡부시험(ELISA)방법측정96례다발성기염/피기염환자(기중다발성기염26례,피기염70례)화35명건강체검자혈청sHLA-G수평,분석혈청sHLA-G여다발성기염/피기염환자림상특정、실험실지표급치료、예후적관계.결과 혈청sHLA-G수평재다발성기염/피기염환자[(44±70) U/ml]명현고우건강대조자[(4±5)U/ml,P＜0.01)].피기염환자조혈청sHLA-G수평[(54±81) U/ml]명현고우다발성기염환자조[(27±41) U/ml,P=0.004].혈청sHLA-G승고조다발성기염/피기염환자중탄인곤난적발생솔교sHLA-G정상조명현승고(P=0.001).sHLA-G수평여CD3+T세포화CD4+T세포수평균정부상관(r=-0.233,P=0.047；r=-0.287,P=0.015),여보체C3수평정정상관(r=0.284,P=0.021).초치조환자혈청sHLA-G수평[(77±99) U/ml]현저고우경치조[(34±52) U/ml,P=0.021].단혈청sHLA-G수평여질병활동도무명현상관,당피질격소급면역억제제치료대혈청sHLA-G수평야무명현영향.결론 혈청sHLA-G수평재다발성기염/피기염환자중명현승고,병차여외주혈CD3+화CD4+T세포수정부상관,림상상여탄인곤난적발생상관,제시sHLA-G가능재다발성기염/피기염병리과정중발휘일정작용.
Objective To investigate the serum levels of soluble human leukocyte antigen (sHLA)-G in patients with polymyositis (PM) or dermatomyositis (DM),and to analyze its association with clinical features and possible role in the pathogenesis of PM/DM.Methods Serum sHLA-G levels of 26 patients with PM,70 patients with DM and 35 matched healthy controls were measured by ELISA.The relationship between the sHLA-G levels and clinical features or seroimmunological data in the patients with PM/DM was analyzed.Results Serum levels of sHLA-G in PM/DM patients were significantly higher compared to healthy controls [(44±70) U/ml vs (4±5) U/ml,P＜0.01].There was statistically significant difference between DM patients and PM patients [(54±81) U/ml vs (27±41) U/ml,P=0.004].The incidence of dysphagia was significantly higher in sHLA-G elevated group than those in sHLA-G normal group (P=0.001).Additionally,Spearman rank correlation analysis showed that the serum sHLA-G levels were positively correlated with serum C3 (r=0.284,P=0.021),but negatively correlated with CD3+ T cells (r=-0.233,P=0.047) and CD4+ T cells (r=-0.287,P=0.015) in the peripheral blood in patients with PM/DM.Serum levels of sHLA-G in non-treated PM/DM patients were significantly higher compared to treated patients [(77±99) U/ml vs (34±52) U/ml,P=0.021].No relationship between serum sHLA-G levels and PM/DM disease activity,or different drug therapy was found.Conclusion Serum levels of sHLA-G are increased in PM/DM patients.The increased production of sHLA-G,paralleled with higher incidence of dysphagia and lower level of CD3+ T cells and CD4+ T cells,indicates that sHLA-G may play an important role in the pathogenesis of PM/DM.