类风湿关节炎患者血清低氧诱导因子-1α水平与肺间质病变的关系

Correlation of serum hypoxia-inducible factor-1α level with interstitial lung disease in patients with rheumatoid arthritis

目的探讨类风湿关节炎(RA)患者血清低氧诱导因子-1α(HIF-1α)水平与肺间质病变(ILD)的关系。方法收集RA患者272例,其中合并ILD 68例(RA-ILD组),未合并ILD 204例(RA组),并选择年龄、性别相匹配的健康体检者80例(健康对照组)作为对照。采集3组的静脉血,采用ELISΑ方法检测血清HIF-1α、结缔组织生长因子(CTGF)、转化生长因子-β1(TGF-β1)水平,并检测两组RA患者的肺功能等相关实验室指标。结果与健康对照组相比,RA组及RA-ILD组血清HIF-1α水平显著升高(P<0.01),且RA-ILD组血清HIF-1α、CTGF、TGF-β1水平较RA组明显升高(P<0.01)。RA-ILD组肺活量占预计值百分比、用力肺活量占预计值百分比和一氧化碳弥散量占预计值百分比(DLCO%)较RA组患者明显降低(P<0.05,P<0.01)。RA患者血清HIF-1α与类风湿因子呈正相关(r=0.80,P<0.01),与抗环瓜氨酸抗体呈正相关(r=0.59,P<0.01),与DLCO%呈负相关(r=-0.76,P<0.01)。结论 HIF-1α参与RA的发病过程,且可能与RA合并ILD的发病相关。

Objective To investigate the correlation of serum hypoxia inducible factors - 1 α （HIF - 1 α） level with interstitial lung disease （ILD） in patients with rheumatoid arthritis （RA）. Methods Two hundred and seventy - two RA patients were enrolled in the study, of whom 68 cases had associated ILl） （RA - ILD group） and 204 cases did not （RA group）. Eighty subjects scheduled for healthy physical examination and with age and sex matched were enrolled as control （normal control group）. Venous blood of the 3 groups was collected and concentrations of serum HIF - 1 α, connective tissue growth factor （CTGF） and transforming growth factor - β1 （TGF - β1 ） were measured by ELISA. Lung function and related laboratory indicators in patients with RA were detected. Results HIF - 1α concentrations of the RA - ILD and RA groups were significantly higher than that of the normal control group （ P 〈 0. 01 ）. Concentrations of HIF - 1α, CTGF and TGF - β1 of the RA - ILD group were significantly higher than those of the RA group （P 〈 0. 01 ）. Vital capacity, forced vital capacity and carbon monoxide diffusing capacity （DLCO） of the RA -ILD group were significantly lower than those of the RA group （ P 〈 0. 05, P 〈 0. 01 ）. Serum level of HIF - 1 ct in RA patients was positively correlated with that of rheumatoid factor （ r = 0. 80, P 〈 0. 01 ） and anti - cyclic citrullinated peptide antibody （ r = 0. 59, P 〈 0. 01 ）, and was negatively correlated with DLCO （ r = - 0. 76, P 〈 0. 01 ）. Conclusion HIF - 1 α participates in the pathogenesis of RA, and may be involved in the pathogenesis of RA associated ILD.