摘要
目的探讨类风湿因子(RF),抗环瓜氨酸肽(CCP)抗体,涎液化糖链抗原-6(KL-6)在类风湿关节炎(RA)合并肺间质病变(ILD)病人中的表达及与疾病的相关性。方法回顾性研究2018年5月至2021年5月大同市第五人民医院收治的125例RA病人,根据病人病情分为单纯RA组及RA合并ILD组,按照年龄、性别随机分层选择60例健康体检者为对照组。收集一般资料,比较三组研究对象的年龄、性别、C-反应蛋白(CRP)、红细胞沉降率(ESR)、疾病活动性评分(DAS28)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、用力肺活量(FVC)、第一秒用力呼吸末容积(FEV_(1))、第一秒用力呼吸末容积与用力肺活量比值(FEV_(1)/FVC)等指标;采用酶联免疫吸附法检测血清中RF、抗CCp、KL6表达水平,Pearson法分析RF、抗CCp、KL6与相关指标表达的相关性,采用多重线性回归分析RA合并ILD病人RF、抗CCp、KL6表达水平的影响因素。利用受试者工作特征(ROC)曲线评价血清RF、抗CCp、KL6水平对RA合并ILD病人的诊断价值。结果RA合并ILD组与单纯RA组病人血清中RF[(572.25±118.54)、(312.66±58.23)IU/mL)]、抗CCp[(255.44±74.56)、(152.36±50.28)IU/mL]、KL6[(619.12±205.68)、(363.70±51.87)U/mL]表达水平均高于健康对照组[(85.51±9.49)IU/mL,(63.83±11.85)IU/mL,(317.25±48.87)U/mL],且RA合并ILD组高于单纯RA组(P<0.05);RA合并ILD病人血清中RF、抗CCp表达呈正相关(r=0.45,P<0.05),RF与KL6表达呈正相关(r=0.44,P<0.05),抗CCp、KL6表达呈正相关(r=0.42,P<0.05);RA合并ILD病人血清中RF、抗CCp、KL6表达与CRP、ESR、DAS28、CRP、ESR、DAS28表达均呈正相关,与FVC、FEV_(1)表达均呈负相关(P<0.05)。三者联合检测RA合并ILD病人的AUC 95%CI为0.99(0.96,1.00),灵敏度和特异度分别为97.96%、96.05%。结论在RA合并ILD病人血清中RF、抗CCp、KL6表达水平明显升高,且联合检测三者对诊断RA合并ILD病人具有重要意义。
Objective To investigate the expression of rheumatoid factor(RF),anti-cyclocitrulline peptide(CCP)antibody,krebs vonden lungen-6(KL-6)in patients with rheumatoid arthritis(RA)and interstitial lung disease(ILD),and their relationship with disease.Methods One hundred and twenty-five RA patients admitted to The Fifth People's Hospital of Datong from May 2018 to May 2021 were retrospectively studied.According to the patient's condition,they were divided into a simple RA group and an RA combined with ILD group.They were assigned into simple RA group and RA combined ILD group according to their condition.According to age and gender,60 healthy subjects were randomly selected as control group.The general data were collected and the age,gender,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),disease activity score(DAS28),immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),forced vital capacity(FVC),forced end-respiratory volume in the first second(FEV_(1)),ratio of forced end-respiratory volume in the first second to forced vital capacity(FEV_(1)/FVC)and other indicators were compared among the subjects.Enzyme-linked immunosorbent assay was performed to detect the expression levels of RF,anti-CCP,and KL6 in serum;Pearson method was performed to analyze the correlation between the expression of RF,anti-CCP,KL6 and related indexes;the influencing factors of the expression levels of RF,anti-CCP and KL6 in RA patients with ILD were analyzed by multiple linear regression.Receiver operating characteristic(ROC)curve was performed to evaluate the diagnostic value of serum RF,anti-CCP,and KL6 levels in patients with RA and ILD.Results The expression levels of serum RF[(572.25±118.54),(312.66±58.23)IU/mL],anti-CCP[(255.44±74.56),(152.36±50.28)IU/mL]and KL6[(619.12±205.68),(363.70±51.87)U/mL]in the RA combined with ILD group and the RA group were higher than those in the healthy control group[RF:(85.51±9.49)IU/mL,anti-CCP:(63.83±11.85)IU/mL,KL6:(317.25±48.87)U/mL],and those in RA combined with ILD group were higher than those in the RA group(P<0.05);the expression of RF and anti-CCP in the serum of patients with RA combined with ILD was positively correlated(r=0.45,P<0.05),RF was positively correlated with the expression of KL6(r=0.44,P<0.05),and the expression of anti-CCP and KL6 was positively correlated(r=0.42,P<0.05);the expressions of RF,anti-CCP and KL6 in serum of patients with RA complicated with ILD were positively correlated with the expressions of ESR,DAS28CRP,ESR,DAS28,IgACRP,ESR,DAS28,and negatively correlated with the expressions of CRP,IgG,IgM,FVC,FEV_(1),FVC and FEV_(1)(P<0.05).The AUC 95%CI of the three combined detection for RA patients with ILD was 0.99(0.96,1.0),and the sensitivity and specificity were 97.96%and 96.05%,respectively.Conclusion The expression levels of RF,anti-CCP and KL6 in serum of RA patients with ILD were significantly increased,and the combined detection of the three was of great significance for the diagnosis of RA patients with ILD.
作者
赵颖
张向东
王贯虹
ZHAO Ying;ZHANG Xiangdong;WANG Guanhong(Department of Rheumatology and immunology,The Fifth People's Hospital of Datong,Datong,Shanxi 037000,China)
出处
《安徽医药》
CAS
2023年第10期1995-1999,共5页
Anhui Medical and Pharmaceutical Journal
关键词
关节炎
类风湿
肺间质病变
类风湿因子
抗环瓜氨酸肽
涎液化糖链抗原-6
Arthritis,rheumatoid
Interstitial lung disease
Rheumatoid factor
Anti-cyclocitrulline peptide
Krebs vonden lungen-6
