皮肌炎患者血清中趋化因子CCL27的检测及临床意义

The serum levels of chemokine CCL27 in patients with dermatomyositis,and its clinical relevance

目的检测DM患者血清中趋化因子CCL27水平并探讨其临床意义。方法ELISA法检测58例DM患者,21例PM患者,20例SLE患者以及31名健康者血清中CCL27水平;利用国际肌炎组织制定的炎性肌病评价工具(MDAAT)评估DM患者疾病活动度,并分析血清CCL27水平与疾病活动度的相关性。多组间比较用单因素方差分析,2组间比较用t检验,横断面相关性分析采用Spearman秩相关和多元线性回归,广义估计方程(GEE)模型对于纵向数据进行分析。结果DM患者血清CCL27水平(178±49)pg/ml高于PM(110±40)pg/ml,SLE(141±46)pg/ml以及健康者(137±38)pg/ml,差异有统计学意义(F=14.192,P<0.01)。横断面研究发现血清CCL27水平与DM患者肌炎疾病活动性评估视觉模拟量表评分(MYOACT)-总体活动度(r=0.301,P=0.022)和MYOACT-皮肤黏膜活动度评分呈正相关(r=0.493,P<0.01)。伴有V形疹的DM患者血清CCL27水平[(191±52)pg/ml]高于无Ⅴ形疹患者[(153±33)pg/ml](t=2.839,P<0.01),伴有枪套征的DM患者血清CCL27水平[(196±58)pg/ml]高于无枪套征患者[(168±41)pg/ml](t=2.176,P=0.034)。随访研究发现血清CCL27水平随DM患者MYOACT-总体活动度(β=0.031,P=0.042)和MYOACT-皮肤黏膜活动度变化(β=0.032,P<0.01),呈正相关。结论DM患者血清CCL27水平显著升高,并且与皮肤疾病活动度显著相关,可以作为DM患者皮肤损伤标识物以及监测皮疹治疗的指标。

Objective To determine the serum levels of chemokine CCL27 and its clinical relevancein patients with dermatomyositis(DM).Methods The serum CCL27 levels of 58 DM patients,21 polymyositis(PM)patients,20 systemic lupus erythematosus(SLE)patients and 31 healthy controls were measured by enzyme linked immunosorbent assay(ELISA).The score of disease activity was measured by two physicians-based on the myositis disease activity assessment tool(MDAAT).Its correlation with serum levels of CCL27 was analyzed.The difference between multiple groups were compared using analysis of variance(ANOVA)and t test,and the relevance was analyzed using Spearman correlation analysis and generalized method of moments(GEE)model.Results Theserum level of CCL27 in DM patients(178±49)pg/ml was significantly higher than PM(110±40)pg/ml,SLE(141±46)pg/ml and healthy controls(137±38)pg/ml(F=14.192,P<0.01).Crosssectional analysis showed that the serum CCL27 levelwaspositively correlated with global disease activity(r=0.301,P=0.022)andskin disease activity(r=0.493,P<0.01).Patients with V sign had higher serum CCL27 levels(191±52)pg/ml than the patients without(153±33)pg/ml(t=2.839,P<0.01).Patients with holster sign had higher serum CCL27 levels(196±58)pg/ml than the patients without(168±41)pg/ml(t=2.176,P=0.034).Follow-up study also found that CCL27l evels were positively correlated with global disease activity(β=0.031,P=0.042)and skin disease activity(β=0.032,P<0.01).Conclusion The serum CCL27 levels are increased in patients with DM and can reflect the skin disease activity.The results of this study suggest that CCL27 may be a marker for cutaneous damage and monitoring of therapeutic effect.