IgG4相关性疾病患者临床特征和血清炎症免疫八项结果回顾性分析

Retrospective Analysis of Clinical Characteristics and Clinical laboratory Results in Patients with IgG4-Related Diseases

目的探讨IgG4相关性疾病(IgG4-RD)患者的临床特征及血清炎症免疫八项[C-反应蛋白(CRP)、血沉(ESR)、补体C3(C3)、补体C4(C4)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白E(IgE)]在IgG4-RD中的检测价值。方法回顾性分析2020年1月至2022年7月郑州大学第一附属医院收治的52例IgG4-RD患者的临床资料和实验室检查数据,以同期年龄、性别相匹配的56例健康体检者为健康对照组。比较两组炎症免疫八项结果。通过Pearson相关性分析评估各指标间的关系。结果52例IgG4-RD患者中,胰腺-胆囊-肝脏为最常见的累及部位,其次为眼、泪腺、唾液腺。40例(76.9%)患者表现为≥2个器官受累,12例(23.1%)患者表现为单一器官受累。血清CRP、ESR、C3、C4、IgG、IgE异常占比分别为44.9%、67.4%、47.5%、32.5%、62.5%、83.3%。与健康对照组相比,IgG4-RD组血清CRP、ESR、IgG、IgE水平升高(P<0.001),C3、C4水平降低(P<0.001);两组IgA、IgM水平差异无统计学意义(P>0.05)。相关性分析发现IgE与IgG4水平呈正相关(r=0.433,P=0.034),与C4水平呈负相关(r=-0.457,P=0.028)。结论IgG4-RD患者临床表现缺乏特异性,常累及多个器官。血清炎症免疫八项检测对IgG4-RD诊断有一定参考价值,IgE或与IgG4-RD发生发展密切相关。

Objective To explore the clinical characteristics and detection value of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),complement 3(C3),complement 4(C4),immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin E(IgE)in IgG4-related diseases(IgG4-RD).Methods The clinical data and laboratory results of 52 patients diagnosed as IgG4-RD in the First Affiliated Hospital of Zhengzhou University from January 2020 to July 2022 were retrospectively analyzed,and 56 healthy people matched in age and sex in the same period were taken as the healthy control group.The expression differences of CRP,ESR,C3,C4,IgA,IgG,IgM and IgE between the two groups were compared.Pearson correlation analysis was used to evaluate the correlation among the indicators.Results Among 52 patients with IgG4-RD,pancreas-gallbladder-liver were the most common involved organs,followed by head,lacrimal glands and salivary glands.Forty patients(76.9%)showed more than two organs involvement,and only 12 cases(23.1%)showed one single organ involvement.The abnormal rates of CRP,ESR,C3,C4,IgG and IgE were 44.9%,67.4%,47.5%,32.5%,62.5%and 83.3%respectively.Compared with the healthy control group,the levels of CRP,ESR,IgG and IgE in IgG4-RD group were increased(P<0.001).While the levels of C3 and C4 were markedly decreased(P<0.001).Levels of IgA and IgM showed no significant difference between the two groups(P>0.05).Correlation analysis showed IgE was positively correlated with IgG4(r=0.433,P=0.034)and negatively correlated with C4(r=-0.457,P=0.028).Conclusion The clinical manifestations of IgG4-RD lack specificity and often involve multiple organs.Detection of CRP,ESR,C3,C4,IgA,IgG,IgM and IgE exhibited certain reference value for the diagnosis of IgG4-RD and IgE was closely related with the occurrence and development of IgG4-RD.