类风湿性关节炎相关间质性肺疾病患者血清sICAM-1变化特征及临床意义研究

Changes and significance of serum sICAM-1 in patients with rheumatoid arthritis-associated interstitial lung disease

目的分析类风湿性关节炎相关间质性肺疾病患者(RA-ILD)血清可溶性细胞间黏附分子-1(sICAM-1)表达水平变化特征及临床意义。方法将2016年1月至2017年12月诊治的RA-ILD患者21例(RA-ILD组)、无间质性肺疾病(ILD)类风湿关节炎(RA)患者15例(RA组),以及同期体检健康者12例(对照组)纳入本研究,收集研究对象临床资料,以及肺功能、血清sICAM-1检测结果。结果RA-ILD组、RA组血清sICAM-1水平高于对照组(P<0.05);RA-ILD组血清sICAM-1水平高于RA组(P<0.05)。RA-ILD肺部病变进展期患者血清sICAM-1水平高于稳定期患者(P<0.05)。血清sICAM-1阈值为518ng/mL时,对RA-ILD肺部病变进展期与稳定期鉴别诊断灵敏度为80%、特异度为82%(P<0.05)。血清sICAM-1水平与RA-ILD患者用力肺活量、肺部一氧化碳扩散能力呈负相关(P<0.05)。结论血清sICAM-1检测可用于RA-ILD肺部疾病进展期或稳定期鉴别诊断,对判断RA-ILD病情程度也有一定的指导意义。

Objective To investigate the changes and significance of serum soluble intercellular adhesion molecule(sICAM-1) in patients with rheumatoid arthritis(RA)-associated interstitial lung disease(ILD,RA-ILD). Methods From Jan.2016 to Dec.2017,21 patients with RA-ILD(RA-ILD group),15 RA patients without ILD(RA group) and 12 healthy subjects(control group) were enrolled.The basic clinical data,and detected results of lung function and serum sICAM-1 were collected and analyzed. Results Serum sICAM-1 levels in RA-ILD group and RA group were significantly higher than control group( P <0.05).Serum sICAM-1 level in RA-ILD group was significantly higher than RA group( P <0.05).Serum sICAM-1 levels were significantly higher in RA-ILD patients at progression stage than those at stable stage( P <0.05).When the cut-off value was set as 518 ng/mL,the sensitivity and specificity of serum sICAM-1 to identify progression stage and stable stage of RA-ILD group was 80% and 82%( P < 0.05).The serum sICAM-1 level was negatively correlated with forced vital capacity and CO diffusion capacity of lung in RA-ILD patients. Conclusion Serum sICAM-1 could be used for differential diagnosis of progressive or stable stage of RA-ILD pulmonary disease,and might also have certain guiding significance for judging the severity of RA-ILD.