肺部疾病患者血清IgG4水平检测及IgG4/IgG比值的临床价值研究

Clinical value of serum IgG4 level detection and IgG4/IgG ratio in patients with pulmonary diseases

目的 探讨血清免疫球蛋白4(IgG4)在常见肺部疾病诊断中的价值。方法 选取2019年10月至2020年6月呼吸科因肺部阴影待查收治入院并送检血清IgG4的住院患者279例,最终诊断包括肺炎合并纤维化33例;普通肺炎150例;间质性肺炎患者58例;肺部肿瘤患者38例。同时收集本院健康体检者33例。采用免疫散射比浊法定量检测各组血清IgG及IgG4的水平,并得出两者比值,比较各组之间IgG4水平及IgG4/IgG比值。结果 肺炎合并纤维化组IgG4浓度最高为1.02g/L,IgG4/IgG比值为0.08,IgG4>1.35g/L的比例为42.4%,以上指标与其他各组相比较,均有统计学意义(P<0.05)。结论 肺部阴影待查时同时关注血清IgG4浓度及IgG4/IgG比值,有助于提示病变部位存在纤维化改变,在肺部阴影无法明确病因并在现有治疗无效的情况下,血清IgG4检测或可提示医生对IgG4相关性肺疾病的关注,及时采取进一步的诊疗手段。

Objective This paper discusses the value of serum IgG4 in the diagnosis of common pulmonary diseases.Methods 279 hospitalized patients with IgG4 were selected from the respiratory department of our hospital from October 2019 to June 2020 due to pulmonary shadow.The final diagnosis included 33 cases of pneumonia combined with fibrosis,150 cases of common pneumonia,and 58 cases of interstitial pneumonia,38 patients with lung tumor.At the same time,33 cases of health examiner were collected.Immunoturbidimetry was used to quantitatively detect serum IgG and IgG4 levels in each group,and their ratios were obtained to compare the IgG4levels and IgG4/IgG ratios in each group.Results The highest IgG4 concentration,IgG4/IgG ratio and IgG4>1.35g/L ratio in the pneumonia combined with fibrosis group were 1.02g/L,0.08 and 42.4%,respectively.There were statistically significant differences in the above indicators compared with other groups(P<0.05).Conclusion When lung shadow is to be examined,serum IgG concentration and IgG4/IgG ratio should be paid attention to at the same time.An increase in serum IgG4 may indicate fibrosis changes in the lesion site.If the cause of lung shadow cannot be determined and the existing treatment is ineffective,serum IgG4 detection may quickly and easily indicate the clinical possibility of IgG4-RLD,and further diagnosis and treatment measures should be taken in time.