血清可溶性细胞间黏附分子-1在皮肌炎合并间质性肺病患者中的意义研究

Significance of serum soluble intercellular adhesion molecule-1 in dermatomyositis with interstitial lung disease

目的探讨血清可溶性细胞间黏附分子1(sICAM-1)在皮肌炎合并间质性肺病(ILD)患者中的意义。方法回顾性分析中国医科大学附属第一医院2018年1月至2020年2月50例确诊为皮肌炎的患者,按是否合并ILD分为ILD组和非ILD组。收集研究对象的临床资料并使用酶联免疫吸附测定(ELISA)法测量血清sICAM-1水平。根据是否患有ILD以及快速进展性间质性肺病(RP-ILD)将患者分为亚组。比较各组间sICAM-1水平,Pearson法或Spearman秩相关法分析sICAM-1与临床资料的相关性。logistic回归模型分析ILD及RP-ILD发生的危险因素。结果皮肌炎-ILD患者sICAM-1水平高于无ILD患者[(286.01±53.38)μg/L vs.(220.45±28.65)μg/L,P<0.001)]。与无RP-ILD组相比,RP-ILD组s ICAM-1水平显著增加[(331.61±51.41)μg/L vs.(265.29±40.42)μg/L,P<0.001)]。血清sICAM-1水平与皮肌炎-ILD患者用力肺活量、肺部一氧化碳扩散能力呈负相关(r=-0.566,P=0.001;r=-0.538,P=0.002),与磨玻璃评分、纤维化评分呈正相关(r=0.634,P<0.001;r=0.553,P=0.001)。结论血清sICAM-1水平可能对判断皮肌炎-ILD病情严重程度有一定的指导意义。

Objective to study the significance of serum soluble intercellular adhesion molecule-1(sICAM-1) in dermatomyositis(DM) patients with interstitial lung disease(ILD). Methods Fifty patients diagnosed with dermatomyositis were retrospectively analyzed and they were divided in to ILD group and non-ILD group in First Affiliated Hospital,China Medical University from Jan. 2018 to Feb. 2020. Clinical data were collected and serum sICAM-1 levels were measured using an enzyme linked immunosorbent assay(ELISA) method. Patients were divided into subgroups according to whether they had ILD or rapidly progressive interstitial lung disease(RP-ILD). Compare the levels of sICAM-1 between groups, Pearson method or Spearman rank correlation method was used to analyze the correlation between sICAM-1 and clinical data. The logistics regression model analyzes the risk factor of ILD and RP-ILD. Results The sICAM-1 levels were higher in DM-ILD patients than in patients without ILD[(286.01±53.38)μg/L vs.(220.45±28.65)μg/L,P<0.001)]. The sICAM-1 levels were significantly increased in RP-ILD group compared to non-RP-ILD group[(331.61±51.41)μg/L vs.(265.29 ± 40.42)μg/L,P<0.001)]. Serum sICAM-1 levels were negatively correlated with forced vital capacity and carbon monoxide diffusing capacity in DM-ILD patients(r=-0.566,P=0.001;r=-0.538,P=0.002)and positively correlated with ground glass opacity score and fibrosis score(r=0.634,P<0.001;r=0.553,P=0.001). Conclusion Serum s ICAM-1 levels may be instructive in determining the severity of DM-ILD.