结缔组织病合并间质性肺病患者血清学检测结果分析

Analysis of serological test results for patients with connective tissue disease complicated with interstitial lung disease

目的分析结缔组织病合并间质性肺病(CTD-ILD)患者血清学检测结果,并与特发性间质性肺炎(IIP)血清学检测结果进行比较。方法我院收治的CTD-ILD患者及IIP患者各62例,进行血清学检查,包括自身抗体系列(ANA、RNP、rRNP、Anti-SSA、Anti-SSB、Anti-ds-DNA、Anti-Smith、Anti-Scl-70、Anti-Jo-1)、风湿二项(RF、Anti-CCP)、抗中性粒细胞包浆抗体(ANCA)、免疫球蛋白(IgA、IgG、IgM)、补体(C3、C4)和细胞炎性因子(IL-32、IL-12)。结果 CTD-ILD组自身抗体、风湿二项及ANCA均出现阳性,IIP组仅有ANA和RF出现阳性,且IIP组ANA和RF阳性率低于CTD-ILD组(P<0.05);两组IgA和IgG水平比较,差异无统计学意义(P>0.05)。CTD-ILD组IgM、IL-32和IL-12水平高于IIP组,C3和C4水平低于IIP组(P<0.05)。结论 CTD-ILD患者自身抗体系类、风湿二项和ANCA中至少一项呈阳性,且相对于IIP患者,IgM水平明显较高,补体水平明显较低,血清IL-32和IL-12水平明显较高。

Objective To analyze the serological test results of patients with connective tissue disease complicated with interstitial lung disease（ CTD-ILD）,and compare with the serological test results of idiopathic interstitial pneumonia（ IIP）.Methods Sixty-two CTD-ILD patients and 62 IIP patients treated in our hospital from August 2012 to August 2016 were selected for the study and given the serological tests including autoantibodies series（ ANA,RNP,rRNP,Anti-SSA,Anti-SSB,Anti-ds-DNA,Anti-Smith,Anti-Scl-70 and Anti-Jo-1）,two items of rheumatism（ RF and Anti-CCP）,antineutrophil cytoplasmic antibody（ ANCA）,immunoglobulins（ IgA,IgG and IgM）,complements（ C3 and C4） and inflammatory cytokines（ IL-32 and IL-12）.Results The autoantibodies,two items of rheumatism and ANCA were positive in the CTD-ILD group,and only ANA and RF were positive in the IIP group,and the positive rates of ANA and RF in the IIP group were lower than those in the CTD-ILD group（ P〈0. 05）.There was no statistically significant difference in IgA and IgG levels between the two groups（ P〈0. 05）.The levels of IgM,IL-32 and IL-12 in the CTD-ILD group was significantly higher while C3 and C4 levels were significantly lower than those in the IIP group（ P〈0. 05）.Conclusion At least one of the autoantibodies,two items of rheumatism and ANCA are positive in CTD-ILD patients,and the levels of IgM,serum IL-32 and IL-12 are significantly higher and the complement levels are significantly lower than those in IIP patients.