血清YKL-40水平与多肌炎/皮肌炎的相关性

Correlation between serum YKL-40 and polymyositis/dermatomyositis

目的:探究血清YKL-40水平与多肌炎/皮肌炎(polymyositis/dermatomyositis,PM/DM)的相关性。方法:纳入99例确诊为PM/DM患者和87例健康者(对照组)。ELISA检测血清YKL-40水平,记录患者临床相关指标。以肌病活动性视觉模拟评分评估疾病的活动性,以发生间质性肺病(interstitial lung disease,ILD)评估疾病的严重程度。结果:PM/DM患者血清YKL-40水平显著高于对照组,差异有统计学意义。血清YKL-40水平与视觉模拟评分(r=0.65,P<0.01)、C反应蛋白(r=0.33,P<0.01)、红细胞沉降率(r=0.65,P<0.01)、铁蛋白(r=0.62,P<0.01)呈正相关。PM/DM患者中合并ILD患者血清YKL-40水平显著高于非ILD患者,差异有统计学意义。YKL-40可用于评估ILD的诊断(ROC曲线下面积为0.82,P<0.01)。结论:血清YKL-40水平可用于评估PM/DM的疾病活动性和严重程度。

Objective:To investigate the correlation between serum YKL-40 and polymyositis/dermatomyositis (PM/DM). Methods:A total of 99 patients with definite PM/DM were prospectively enrolled.87 healthy individuals were set as a control.Serum YKL-40 levels were determined using ELISA.The clinical characteristics of PM/DM were recorded.Disease activity of PM/DM was estimated using myositis disease activity assessment visual analogue scale.Disease severity was estimated by the occurrence of interstitial lung disease (ILD).Results:The patients with PM/DM had significantly higher serum YKL-40 concentrations than the healthy controls.Serum YKL-40 levels were positively correlated with myositis disease activity assessment visual analogue scale (r=0.65,P<0.01), C-reactive protein (r=0.65,P<0.01),erythrocyte sedimentation rate (r=0.65,P<0.01) and ferritin (r=0.65, P<0.01).Patients with ILD had significantly higher YKL-40 concentrations than those without.The area under receiver operating characteristic curve of YKL-40 for identifying ILD was 0.87 (P<0.01).Conclusion:Serum YKL-40 is a useful biomarker for estimating disease activity or severity of PM/DM.