类风湿关节炎血清中CCL19和CCL21的表达水平与肺间质病变的关系

摘要

Objective:To investigate the relationships between the expression levels of chemokines CCL19 and CCL21 in serum of patients with RA and interstitial lung disease,as well as the correlation between the chemokines and the clinical parameters.Methods:Patients hospitalized in the First Hospital of China Medical University from May 2016 to March 2017 were enrolled.Serum levels of CCL21 and CCL19 in the 62 patients with RA,among them,34 cases without pulmonary interstitial lesions while 28 cases with lung interstitial diseases,18 cases ⅡP and 20 health control were detected with enzyme-linked immunosorbent assay (ELISA).One-way ANOVA,LSD-t test,Kruskal-Wallis test,Pearson and Spearman correlation analysis were used for statistical analysis.Results:The levels of CCL21 and CCL19 were both higher in the RA patients than the health controls(P＜0.05;P＜0.01),The concentrations of CCL21 in serum of the RA patients with ILD were higher than thoes without ILD,higher than the health controls (P＜0.05;P＜0.01),serum levels of CCL21 in the ⅡP patients were higher than the health controls (P＜0.01),too.The serum levels of CCL21 in men were higher than women(P＜0.05).Serum CCL21 levels were negatively correlated with albumin and BMI(r=-0.280,P＜0.05;r =-0.605,P＜0.05).Levels of CCL19 were negatively correlated with the levels of C4 (r =-0.326,P＜0.05),and positively correlated with the levels of D-Dimer(r =0.592,P＜0.05).Conclusion:Chemokines CCL21 and CCL19 are highly expressed in serum of patients with RA,they may be involved in the pathogenesis of RA.Furthermore,CCL21 may has a correlation with the lung interstitial lesion in RA.%目的:探讨趋化因子CCL19和CCL21在类风湿关节炎(RA)患者血清中的表达水平与肺间质病变之间的关系,以及与临床指标间的相关性.方法:收集2016年5月至2017年3月于中国医科大学附属第一医院住院的RA患者62例,其中肺间质未受累的34例,合并肺间质改变的28例,特发性间质性肺炎(ⅡP)患者18例,以健康正常人20例为对照组.ELISA测定血清中的CCL21和CCL19水平.采用单因素方差分析,LSD-t检验,Kruskal-Wallis检验,Pearson和Spearman相关分析等进行统计分析.结果:RA患者血清中的CCL21和CCL19水平均高于正常人(P＜0.05;P＜0.01),合并间质性肺炎(ILD)的RA患者血清中CCL21浓度高于无ILD的RA,高于正常人(P＜0.05;P＜0.01);ⅡP患者血清中的CCL21水平比正常人高(P＜0.01);男性血清中的CCL21水平高于女性(P＜0.05);RA患者血清中CCL21水平与白蛋白和BMI负相关(r=-0.280,P＜0.05;r=-0.605,P＜0.05);CCL19水平与C4水平负相关(r=-0.326,P＜0.05),与D-二聚体水平正相关(r=0.592,P＜0.05).结论:趋化因子CCL21和CCL19在RA患者血清中高表达,可能参与了RA的发病过程,其中CCL21可能还参与了RA的肺间质受累过程.