血清神经营养因子在皮肌炎伴间质性肺病中的临床意义

Serum neurotrophin profiles in dermatomyositis complicated with interstitial lung damage

目的 探讨神经营养因子（NTs）在DM伴有间质性肺病（ILD）患者血清中的水平及其临床意义.方法 筛选47例DM患者,分为ILD组（30例）及非ILD组（17例）.20名健康献血者为对照.ELISA方法检测血清神经生长因子（NGF）、神经营养因子（NT）-3、脑源性神经营养因子（BDNF）的水平.收集患者的临床资料,评价该3种NTs在DM伴ILD中的意义.采用方差分析比较各组NTs水平的差异,组间的比较采用t检验或t＇检验并经Bonferroni校正.相关分析采用Pearson检验.结果 健康对照组、非ILD组及ILD组的血清NGF水平分别为[（182±43）,（308±72）和（480±96） pg/ml],3组间差异有统计学意义（F=90.3,P＜0.01）,ILD组及非ILD组血清NGF水平均显著高于健康对照组（t值分别为12.9和6.5,P值均＜0.01）,且ILD组亦显著高于非ILD组（t=6.4,P＜0.01）.血清NT-3水平在3组间差异无统计学意义.而ILD组[（792±106） pg/ml]及非ILD组[（963±93） pg/ml]血清BDNF水平均显著低于健康对照组[（1 281±107） pg/ml]（t值分别为15.9和9.6,P均＜0.01）,且ILD组血清BDNF水平较非ILD组亦显著降低（t=5.6,P＜0.01）.相关分析显示ILD组NGF与CRP水平呈明显正相关关系（r=0.56,P＜0.01）,而BDNF与CRP水平呈明显负相关关系（r=-0.48,P＜0.05）.结论 明显变化的神经营养因子在DM,尤其在伴有ILD的DM中可能具有重要作用.

Objective To investigate the profiles of serum nerve grow factor profile （NGF）,neurotrophin （NT）-3,as well as brain-derived neurotrophic factor （BDNF） in patients with dermatomyositis （DM） complicated with interstitial lung damage （ILD）.Methods Forty-seven patients were divided into 2 groups：ILD group （30 patients） and non-ILD group （17 patients）.Twenty healthy blood donors were used as controls.Serum levels of NGF,NT-3,as well as BDNF were measured serum by enzyme-linked immunosorbent assay （ELISA）.ANOVA was used to compare serum level of NTs.When a significant difference was found,the exact P-values were calculated using the student＇s t-test or t-test followed by Bonferroni＇s correction.Pearson test was used for correlation analysis.Results The serum NGF levels in healthy control group,the non-ILD group and the ILD group were （182±43）,（308±72）,（480±96） pg/ml respectively.There was statistically significant difference between the three groups （F=90.3,P＜0.01）,and the serum NGF levels were elevated significantly in ILD and non-ILD patient groups as compared with healthy controls （t=12.9 and t=6.5 respectively,both P＜0.01）.The serum level of NGF was significantly higher in ILD group than that in the non-ILD group （t=6.4,P＜0.01）.There was no significant difference in the serum levels of NT-3 among the two patient groups and healthy controls.On the contrary,BDNF levels were significantly decreased in both ILD [（792± 106） pg/ml] and non-ILD patients groups [（963±93） pg/ml] when compared with healthy controls [（1 281±107） pg/ml] （t=15.9 and t=9.6 respectively,both P＜0.01）.The decrease was also significant in ILD group when compared with non-ILD group （t=5.6,P＜0.01）.Moreover,NGF and BDNF both showed significant correlation with serum C-reactive protein （CRP） level in ILD group by applying Pearson correlation analysis （r=0.56,P＜0.01; r=-0.48,P＜0.05 respectively）.Conclusion Neurotrophins may play an import role in the pathogenesis of DM.