皮肌炎患者血清载脂蛋白E变化及意义

Elevated Serum ApoE Levels are Associated with Dermatomyositis and its Clinical Significance

目的探讨皮肌炎患者血清载脂蛋白E动态变化及临床意义。方法收集皮肌炎患者65例,测定血清载脂蛋白E(ApoE)、CRP水平。动态观察皮肌炎患者治疗前后血清ApoE、CRP水平变化趋势,并比较好转者与未好转者各指标的差异。结果皮肌炎组与皮肌炎伴肿瘤组血清ApoE(57.7±15.4、72.3±18.2mg/L)、CRP(35.6±15.9、64.5±23.1mg/L)水平明显升高,差异有统计学意义(P<0.05)。ROC曲线分析显示,血清ApoE水平在51.2 mg/L时,诊断皮肌炎有最佳的敏感度和特异性分别为75.3%和71.4%,ROC曲线下面积为0.773。皮肌炎伴肿瘤组治疗后未好转组血清ApoE水平持续维持在较高水平,与好转者比较差异有统计学意义(P<0.05)。皮肌炎血清ApoE水平与CRP呈正相关(r=0.335,P<0.05)。结论 ApoE是反映皮肌炎的潜在指标,从一定程度上可判断皮肌炎的严重程度以及患者的预后。

Objective To investigate the changes of serum apolipoprotein E（ApoE） in patients with dermatomyositis and its clinical significance.Methods Sixty five dermatomyositis patients were included in the study.The levels of serum ApoE,C-reactive protein （CRP） were determined.The dynamic changes of these parameter were observed in all patients before and after therapy.Results The levels of serum ApoE,CRP were significant higher in cancer associated myositis patients compared to dermatomyositis patients （P ＜ 0.05）.Receiver operating characteristic （ROC） curve was analyzed.If 51.2mg/L serum ApoE was selected as cut-off point of dermatomyositis diagnosis,the sensitivity,specificity and the area of ROC curve was75.3％,71.4％ and 0.773,respectively.In dermatomyositis and cancer associated myositis patients,the levels of serum ApoE were continuously at high level after no-effect therapy,but those in effect therapy group began to decrease.There was significant difference between no-effect therapy group and effect therapy group in the levels of serum ApoE.Correlation analysis showed that the levels of serum ApoE had positive correlation with CRP （r =0.335,P ＜0.05）.Conclusion Serum ApoE is a potential indicators for diagnosing dermatomyositis.Monitoring the changes of serum ApoE may be helpful to predict the severity of disease and to make the prognosis.