骨膜蛋白在皮肌炎和类风湿性关节炎伴间质性肺疾病患者支气管肺泡灌洗液中的检测及临床意义

The detection and clinical role of periostin in BLAF of patients with dermatomyositisand rheumatoid arthritis-related interstitial lung disease

目的检测皮肌炎(DM)和类风湿性关节炎(RA)伴间质性肺疾病(ILD)患者支气管肺泡灌洗液(BALF)中骨膜蛋白的表达及临床意义。方法对44例DM-ILD和28例RA-ILD患者进行支气管肺泡灌洗,回收BALF,检测BALF中骨膜蛋白和涎液化糖链抗原-6(KL-6)水平,并对BALF进行细胞分类计数。对每位患者进行高分辨率CT评分。另选30例无ILD病变的患者作为对照组。结果 DM-ILD和RA-ILD患者BLAF中骨膜蛋白、KL-6水平均明显高于对照组(均P<0.05)。骨膜蛋白水平与BALF中淋巴细胞计数、KL-6水平均呈正相关(均P<0.05)。骨膜蛋白与DM-ILD、RA-ILD患者高分辨率CT评分呈正相关(P<0.05)。结论 DM-ILD和RA-ILD患者BALF中骨膜蛋白水平升高,是CTD-ILD的潜在预测指标。

Objective To explore the expression ofperiostin in bronchoalveolar lavage fluid （BALF） of patients with dermatomyositis-related interstitial lung disease （DM-ILD） and rheumatoid arthritis-related interstitial lung disease （RA-ILD）. Methods A total of 44 patients with DM-ILD and 28 patients with RA-ILD were underwent bronchoalveolar lavage. Cells in BALF were collected and analyzed by absolute different cell counts. The level of periostin and Krebs yon den Lungen-6 （KL-6） were tested by enzyme linked immunosorbent assay. Results of high resolution CT of patients were scored. Thirty patients without interstitial lung disease （ILD） served as a control group. Results Levels of periostin and KL-6 were significantly increased in BALF of patients with DM-ILD and RA-ILD compared with control group （all P〈0.05）. Levels of periostin were positively correlated with lymphocyte counts and levels of KL-6 in BALF （all P〈0.05）. Furthermore, levels of periostin were significantly correlated with high resolution CT scores （P〈0.05）. Conclusions Levels ofperiostin are increased in patients with DM-ILD and RA-ILD. Periostin might be served as an indicator of CTD-ILD.