MiR-21在结缔组织病并间质性肺病患者外周血中的表达及临床意义

Expression and Clinical Significance of MiR-21 in the Peripheral Blood of Patients with CTD-ILD

目的:探讨miR-21在结缔组织病(Connective tissue disease, CTD)并间质性肺病(Interstitial lung disease, ILD)患者外周单个核细胞中的表达及临床意义。方法:选择2015年1月-2018年6月我院收治的202例CTD患者,将其分为CTD-ILD组(n=58)和CTD无ILD组(n=152),对CTD-ILD患者的临床资料进行归纳分析,对不同结缔组织病合并间质性肺疾病组间的临床表现、胸部影像表现进行比较分析。收集两组外周血分离其外周血单个核细胞并采用实时荧光定量PCR法检测各组外周血单个核细胞中miR-21的表达水平,分析CTD-ILD组miR-21与患者临床特征的关系。结果:CTD-ILD的影像学表现多种多样:网格影在SSc、RA、PM/DM患者中多见;蜂窝影多见于SSc的患者;实变影多见于SLE、PM/DM的患者。CTD-ILD组外周单个核细胞中miR-21表达水平较对照组增高,并与肺功能DLCO呈负相关。结论:不同CTD-ILD的发病率不同,临床特点及影像学也各有差异。miR-21对评估CTD-ILD的病变严重程度具有一定价值,可作为诊断CTD-ILD的血清标志物辅助ILD早期诊断与病变程度评估。

Objective: To investigate the expression and clinical significance of miR-21 in the peripheral mononuclear cells of connective tissue disease(CTD) patients complicated with interstitial lung disease(ILD). Methods: 202 patients with CTD in our hospital from January 2015 to June 2018 were divided into the CTD-ILD group(n ≤ 58) and the CTD without ILD group(n ≤ 152). The clinical data of CTD-ILD patients were summarized. The clinical manifestations and chest imaging findings of different CTD-ILD were compared and analyzed. The peripheral blood mononuclear cells of the two groups were isolated and the expression of miR-21 in peripheral blood mononuclear cells of each group was detected by real-time fluorescence quantitative PCR. The relationship between miR-21 in CTD-ILD group and the clinical characteristics of the patients was analyzed. Results: there were a variety of imaging findings of CTD-ILD: grid shadow was more common in patients with SSc, RA, PM/DM, honeycomb shadow was more common in patients with SSc, and solid shadow was more common in patients with SLE, PM/DM. The expression of miR-21 in peripheral mononuclear cells of ILD group was higher than that of control group, and negatively correlated with DLCO of lung function. Conclusion: The incidence varies in different kinds of CTD-ILD. The clinical features and imaging of different types of CTD-ILD are distinct. Mi R-21 may be valuable in evaluating the severity of CTD-ILD, and can be used as a serum marker for the early diagnosis and severity assessment of CTD-ILD.