KL-6在类风湿关节炎相关肺间质病患者中的表达

Expression of KL-6 in patients with rheumatoid arthritis-associated interstitial lung disease

目的 肺泡Ⅱ型细胞表面抗原-6(KL-6)主要表达于Ⅱ型肺泡上皮及支气管上皮细胞,在肺部感染、间质性肺疾病中表达升高,本研究拟探讨KL-6在类风湿关节炎相关性间质性肺疾病中的表达。方法 收集2018年1月-2020年12月在宁夏医科大学总医院风湿免疫科住院的初次诊断且未经治疗的类风湿关节炎(RA)患者68例,其中经胸部CT证实未合并肺间质病变的单纯RA患者35例,合并肺间质病变的RA(RA-ILD)患者33例,同时期健康体检者30名,分别留取3组研究对象血清及部分单纯RA组和RA-ILD组患者关节腔积液,采用EILSA法检测KL-6的表达水平。分析单纯RA组和RA-ILD组患者性别、年龄及病程等临床特征;分析单纯RA组中合并慢性阻塞性肺疾病(COPD)和未合并COPD患者血清KL-6的表达水平。结果 单纯RA组和RA-ILD组患者性别、年龄差异无统计学意义,RA-ILD组患者病程明显长于单纯RA组[(163.50±88.07)月vs.(94.42±50.14)月,P<0.05];单纯RA组中,有6例患者合并COPD,与同组未合并COPD患者比较,血清KL-6水平差异无统计学意义;RA-ILD组患者血清KL-6表达水平[(100.96±14.29)U/mL]明显高于单纯RA组患者[(30.33±5.30)U/mL]及正常对照组[(26.67±2.78)U/mL],单纯RA组血清KL-6水平与正常对照组差异无统计学意义。单纯RA患者关节腔积液KL-6水平明显低于RA-ILD患者,差异有统计学意义(P<0.05)。结论 KL-6在RA-ILD患者中表达增高,是反映RA-ILD患者肺间质病变严重程度的有效指标。

Objective Krebs von den Lungen-6(KL-6) is mainly expressed in type Ⅱ alveolar epithelium and bronchial epithelial cells, and increased in lung infection, interstitial lung disease. This study plans to investigate the expression of KL-6 in rheumatoid arthritis-related interstitial lung diseases. Methods Sixty-eight patients with rheumatoid arthritis(RA) who were diagnosed for the first time and treated in the General Hospital of Ningxia Medical University from January 2018 to December 2020 were collected, including 35 patients with RA without pulmonary interstitial lesions confirmed by chest CT(RA group) and 33 patients with RA with interstitial lung disease(RA-ILD group). Another 30 healthy people at the same time were enrolled. Serum of three groups of patients and joint effusion of some patients in RA group and RA-ILD group were collected respectively, and the expression level of KL-6 was detected by ELISA. The clinical characteristics such as gender, age and course of disease of patients in RA group and RA-ILD group were analyzed. The expression level of KL-6 in serum of patients with chronic obstructive pulmonary disease(COPD) and without COPD in RA group was analyzed. Results There was no significant difference in gender and age between RA group and RA-ILD group. The course of disease in the RA-ILD group was significantly longer than that in the RA group [(163.50±88.07) months vs.(94.42±50.14) months, P<0.05]. In RA group, there were 6 patients with COPD, and there was no significant difference in serum KL-6 level compared with patients without COPD in the same group. The expression level of serum KL-6 in RA-ILD group was(100.96±14.29) U/mL, which were significantly higher than that in RA group [(30.33±5.30) U/mL] and normal control group [(26.67±2.78) U/mL], but there was no significant difference between RA group and normal control group. The level of KL-6 in joint cavity effusion of RA patients was significantly lower than that of RA-ILD patients(P<0.05). Conclusion The expression of KL-6 is increased in RA-ILD patients, and KL-6 is an effective index to reflect the severity of pulmonary interstitial lesions in RA-ILD patients.