实用医学杂志 ›› 2023, Vol. 39 ›› Issue (9): 1148-1152.doi: 10.3969/j.issn.1006⁃5725.2023.09.015

• 临床研究 • 上一篇    下一篇

类风湿关节炎合并肺间质病变患者血清ficolin⁃3、 PTX3表达及临床意义 

高冬梅 张艳春 许文静 李慧心 王莉 佟胜全    

  1. 唐山市工人医院风湿免疫科(河北唐山 063000) 
  • 出版日期:2023-05-10 发布日期:2023-05-10
  • 通讯作者: 佟胜全 E⁃mail:tonnymd@163.com
  • 基金资助:
    河北省 2023 年度医学科学研究课题计划(编号:20231784) 

Expression and clinical significance of serum ficolin⁃3 and PTX3 in patients with rheumatoid arthritis com⁃ plicated with pulmonary interstitial lesions 

GAO Dongmei,ZHANG Yanchun,XU Wenjing,LI Huixin,WANG Li,TONG Shengquan.    

  1. Department of Rheumatology,Tangshan Worker′s Hospital,Tangshan 063000,China
  • Online:2023-05-10 Published:2023-05-10
  • Contact: TONG Shengquan E⁃mail:tonnymd@163.com

摘要:

目的 通过检测血清纤维凝胶蛋白⁃3(ficolin⁃3)、正五聚蛋白 3(pentraxin 3,PTX3)在类风湿 关节炎(rheumatoid arthritis,RA)合并肺间质病变(interstitial lung disease,ILD)患者的表达水平情况,来探 究其在 RA⁃ILD 的临床意义。方法 选取 2020 年 12 月至 2021 年 12 月本院收治的 65 例单纯的 RA 患者作 为 RA 组,70 例 RA⁃ILD 患者作为 RA⁃ILD 组,80 例正常体检健康者为对照组;采用酶联免疫吸附法(ELISA) 检测血清 ficolin⁃3、PTX3 的表达水平;Pearson 法分析 ficolin⁃3、PTX3 的相关性以及二者与 DAS28、ESR、RF、 CRP 及肺功能相关指标的相关性;绘制 ROC 曲线分析 ficolin⁃3、PTX3 对 RA⁃ILD 的诊断价值。结果 RA⁃ILD 组 DAS28、ESR、RF、CRP 值显著高于 RA 组和对照组,RA 组显著高于对照组(P < 0.05);RA⁃ILD 组 的 FVC、VC、DLCO 值显著低于 RA 组和对照组,RA 组显著低于对照组(P < 0.05);RA⁃ILD 组血清 ficolin⁃3 的表达水平显著低于 RA 组和对照组,RA 组表达水平显著低于对照组;RA⁃ILD 组血清 PTX3 的表达水平显 著高于 RA 组和对照组,RA 组表达水平显著高于对照组(P < 0.05);RA⁃ILD 组患者血清中 ficolin⁃3 的表达 水平与 PTX3 呈负相关关系(P < 0.05);ficolin⁃3 与 DAS28、ESR、RF、CRP 的值呈负相关,与FVC、VC、DLCO 的值呈正相关(P < 0.05);PTX3 与 DAS28、ESR、RF、CRP 的值呈正相关,与 FVC、VC、DLCO 的值呈负相关 (P < 0.05);二者联合诊断 RA⁃ILD 的 AUC 高于 ficolin⁃3 和 PTX3 单独诊断的 AUC 值(Z = 6.787,P = 0.009; Z = 15.492,P < 0.001)。结论 RA⁃ILD 患者血清中 ficolin⁃3 表达水平显著降低,PTX3 表达水平显著增高, 二者联合对RA⁃ILD 具有一定的诊断价值。

关键词: 类风湿关节炎, 肺间质病变, 纤维凝胶蛋白?3, 正五聚蛋白3

Abstract:

Objective To investigate the expression of serum ficolin⁃3 and pentraxin 3(PTX3)in patients with rheumatoid arthritis combined with lung interstitial disease(RA ⁃ ILD). Methods From December 2020 to December 2021,65 rheumatoid arthritis(RA)patients in our hospital were enrolled as RA group;70 RA⁃ILD pa⁃ tients as RA⁃ILD group,and 80 healthy subjects as control group. Enzyme⁃linked immunosorbent assay(ELISA) was used to detect the expression level of serum ficolin⁃3 and PTX3;Pearson method was used to analyze the corre⁃ lation of ficolin⁃3 and PTX3 and their correlation with DAS28,ESR,RF,CRP and pulmonary function⁃related in⁃ dexes;ROC curve was drawn to analyze the diagnostic value of ficolin⁃3 and PTX3 in RA⁃ILD. Results The val⁃ ue of DAS28,ESR,RF and CRP in RA ⁃ ILD group was significantly higher than those in RA group and control group,and significant higher value was observed in RA group when compared with the control group(P < 0.05). The value of FVC,VC and DLCO in RA⁃ILD group was significantly lower than that in RA group and the control group,and significant lower value was found in the RA group when compared with the control group(P < 0.05). The expression level of serum ficolin⁃3 in RA⁃ILD group was significantly lower than that in RA group and control group,and the expression level in RA group was significantly lower than that in the control group. The expression level of serum PTX3 in RA⁃ILD group was the highest,followed by RA group and the control group(P < 0.05). Correlation analysis showed that the expression level of ficolin⁃3 in serum of patients in RA⁃ILD group was negative⁃ly correlated with PTX3(P < 0.05);ficolin⁃3 was negatively correlated with the value of DAS28,ESR,RF and CRP,and positively with the value of FVC,VC and DLCO(P < 0.05);PTX3 was positively correlated with the value of DAS28,ESR,RF and CRP,and negatively with the value of FVC,VC and DLCO(P < 0.05). The AUC of the combined diagnosis for RA⁃ILD with ficolin⁃3 and PTX3 was higher than that of ficolin⁃3 or PTX3 alone(Z = 6.787,P = 0.009;Z = 15.492,P < 0.001). Conclusion The expression level of ficolin ⁃3 in serum of patients with RA⁃ILD is significantly decreased,and the expression level of PTX3 is significantly increased. The combina⁃ tion of the two has certain diagnostic value for RA⁃ILD.

Key words: rheumatoid arthritis, interstitial lung disease, fibronectin?3, pentraxin 3