弥漫性结缔组织病相关肺动脉高压与炎症和自身抗体关系研究

Study on the Pulmonary Arterial Hypertension associated with Diffuse Connective Tissue Disease and its Relationship with Inflammation and Autoimmune Antibodies

目的:观察弥漫性结缔组织病相关肺动脉高压的患病率,及其与炎症和自身抗体的关系。方法:纳入观察的弥漫性结缔组织病患者,行彩色多普勒超声肺动脉压力检测,观察红细胞沉降率、C-反应蛋白炎性指标,以及自身抗体ANA、ENA抗体谱。结果:弥漫性结缔组织病相关肺动脉高压的患病率为19.78%(18/91);弥漫性结缔组织病相关肺动脉高压组红细胞沉降率(41.79±2.44)mm·h-1与未合并肺动脉高压组红细胞沉降率(49.35±5.91)mm·h-1比较,以及两组C-反应蛋白[(10.40±1.98)mg·L-1、(13.68±2.02)mg·L-1]比较,差异均无统计学意义(P>0.05)。弥漫性结缔组织病相关肺动脉高压组Scl-70阳性率27.78%与未合并肺动脉高压组Scl-70阳性率4.11%比较,差异有统计学意义(P<0.05)。结论:炎性指标红细胞沉降率、C-反应蛋白与肺动脉高压无明显相关性,说明结缔组织病合并肺动脉高压的机制复杂,可能是多因素共同作用的结果。但某些自身抗体如Scl-70可能与弥漫性结缔组织病相关肺动脉高压相关。

Objective：To investigate the prevalence of pulmonary arterial hypertension associated with diffuse connective tissue disease and its relationship with inflammation and autoimmune antibodies. Methods：Patients with diffuse connective tissue disease were under color doppler ultrasound pulmonary artery pressure testing,observing the erythrocyte sedimentation rate,C-reactive protein inflammatory index,and its antibody ANA and ENA antibody spectrum.Results：The prevalence of pulmonary arterial hypertension associated with diffuse connective tissue disease was 19.78% （18/91）;comparing the erythrocyte sedimentation rate of patients with pulmonary arterial hypertension associated with diffuse connective tissue disease （41.7±2.44） mm·h^-1 with that of those without pulmonary arterial hypertension（49.35±5.91 ）mm·h^-1,and the two group c-reative protein [ （ 10.4±3：1.98 ） mg-L-~, （ 13.68 ±2.02 ） mg·h^-1] the difference had no statistical significance （P 〉 0.05） . Comparing the Scl-70 positive rate of patients with pulmonary arterial hypertension associated with diffuse connective tissue disease with that of those without pulmonary arterial hypertension,the difference had statistical significance （P 〈 0.05） .Conclusion：The inflammatory index such as erythrocyte sedimentation rate and C- reactive protein had no obvious correlation with pulmonary arterial hypertension,which proved that the mechanism of pulmonary arterial hypertension associated with diffuse connective tissue disease was complicated,probably the co-function of multiple factors.But some autoantibodies such as Scl-70 might be relevant to pulmonary arterial hypertension associated with diffuse connective tissue disease.