血清白细胞介素-33检测对类风湿关节炎肺间质病变的价值探讨

Correlation studies of serum interleukin-33 and rheumatoid arthritis-associated interstitial lung disease

目的探讨血清白细胞介素-33(IL-33)与类风湿关节炎(RA)合并肺间质病变(ILD)的相关性。方法纳入RA患者177例,分为RA合并ILD(RA-ILD)组47例与单纯RA组130例,观察并比较2组肺功能等相关实验室指标。测定2组的血清IL-33水平,采用Pearson相关分析探讨IL-33水平及其与相关变量间的关系。结果与RA组相比,RA-ILD组血清IL-33水平更高,差异有统计学意义(P<0.05)。与RA组比较,RA-ILD组的肺活量占预计值百分比(VC%)、用力肺活量占预计值百分比(FVC%)和一氧化碳弥散量(DLCO)均显著降低(P<0.05)。RA-ILD组中36例(占76.6%)出现动脉血氧分压(Pa O2)降低,且RA-ILD组Pa O2明显低于RA组(P<0.05)。RA-ILD组红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)和抗环瓜氨酸多肽抗体(ACPA)水平明显低于RA组(P均<0.05)。相关性分析显示,血清IL-33水平与RF、ACPA滴度呈正相关(r分别为0.90和0.61,P均<0.05),与DLCO水平呈负相关(r=-0.77,P<0.05)。血清IL-33水平与ESR、CRP和Pa O2无相关性。结论 IL-33参与RA的发病过程,且可能与RA-ILD的发病相关。

Objective To study the relationship between serum interleukin-33（ IL-33） and rheumatoid arthritis（ RA）complicated with intemtitial lung disease（ RA-ILD）. Methods 177 cases newly diagnosed as RA were enrolled and were divided into RA group（ n = 130） and RA-ILD group（ n = 47）. The clinical data of the three groups were collected and the serum level of IL-33 was dectected. Pearson＇s correlation analysis was applied to explore the relationship between serum level of IL-33 and related variables. Results The level of IL-33 in RA-ILD group was higher and the levels of VC%,FVC% and DLCO were significantly lower than those in RA group（ P〈0. 05）. There were 36 cases（ 76. 6%） in RA-ILD group with reduced Pa O2,and the level of Pa O2 in RA-ILD group was obviously lower than that of RA group（ P〈0. 05）.The serum level of IL-33 was positively correlated with RF and ACPA（ r = 0. 90,0. 61,P〈0. 05）,and the serum level of IL-33 was negaitively correlated with DLCO（ r =- 0. 77,P〈0. 05）. Conclusions IL-33 participates in the pathogenesis of RA and may be involved in the pathogenesis of RA-ILD.