IgG4与结缔组织病合并间质性肺病的相关性研究

Relationship between IgG4 and Connective Tissue Disease with Interstitial Lung Disease

目的探讨IgG4在结缔组织病合并间质性肺病发病中的意义及与其病情活动的关系。方法选取205例结缔组织病患者，分为两组，其中合并间质性肺病组的患者93例，无间质性肺病组的患者112例。采用动态免疫散射比浊法定量检测两组患者血清中IgG4的水平，比较两组之间IgG4水平的变化；对合并间质性肺病的93例患者同时进行了红细胞沉降率（ESR）、C反应蛋白（CRP）、免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）的检测，分析这些活动性指标与IgG4的相关性。结果（1）结缔组织病合并间质性肺病组患者血清IgG4水平与无间质性肺病组相比差异无统计学意义（P〉0．05）；（2）结缔组织病合并间质性肺病组患者血清IgG4水平与ESR、CRP、IgM、IgA和IgG水平无相关性（P〉0．05）。结论IgG4与结缔组织病合并间质性肺病发病无明显相关性，提示IgG4相关性疾病与结缔组织病是两种相互独立的免疫系统疾病，血清IgG4的水平不能作为评判结缔组织病合并间质性肺病疾病活动的指标。

Objective To discuss the sigoificance of IgG4 in the pathogenesis of connective tissue disease with interstitial lung disease and its relationship with activity of the disease. Methods Totally 205 patients with connective tissue diseases were dividedI into two groups, with 93 with interstitial lung disease and 112 without interstitial lung disease. Serum IgGd levels of all patients were detected by immune nephelometry quantitative method, and IgG4 level changes between the two groups were compared. At the same time, the levels of ESR, C -reactive protein （CRP）, IgA, IgG and IgM were detected in 93 patients with interstitial lung disease, and the correlation of the activity of these indices with IgG4 was analyzed. Results No significant difference in serum IgG4 level was found between the connective tissue disease patients with interstitial lung disease and the pa- tients without interstitial lung disease （ P 〉 0. 05 ）. And in the patients with interstitial lung disease there was no significant corre- lation between the level of serum IgG4 and the levels of ESR, CRP, IgM, IgA and IgG （P 〉 0. 05） . Conclusion The IgG4 level is not correlated with connective tissue disease complicated by interstitial lung disease, suggesting that IgG4 - related diseases and connective tissue disease are two independent immune system diseases, and serum IgG4 level cannot be used to determine the activity of connective tissue disease with interstitial lung disease.