天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (6): 617-621.doi: 10.11958/20210036

• 临床研究 • 上一篇    下一篇

HA、ColⅣ、LN和PⅢNP-P在结缔组织病合并间质性肺病病情评估中的意义

刘晓敏，孙慧莹，王永福，鲁芙爱   

  1. 1内蒙古科技大学包头医学院（邮编014010）；2内蒙古科技大学包头医学院第一附属医院风湿免疫科

  • 收稿日期:2021-01-11 修回日期:2021-02-10 出版日期:2021-06-15 发布日期:2021-06-15
  • 通讯作者: 刘晓敏 E-mail:1282734827@qq.com
  • 基金资助:
    包头医学院科学研究基金项目

The significance of HA, ColⅣ, LN and PⅢNP-P in the evaluation of connective tissue disease with interstitial lung disease

LIU Xiao-min, SUN Hui-ying, WANG Yong-fu, LU Fu-ai #br#   

  1. 1 Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou 014010, China; 2 Department of
    Rheumatology, the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology
  • Received:2021-01-11 Revised:2021-02-10 Published:2021-06-15 Online:2021-06-15

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摘要： 目的 探讨血清透明质酸（HA）、Ⅳ型胶原蛋白（ColⅣ）、层黏连蛋白（LN）和Ⅲ型前胶原N端肽（PⅢNP-P） 在结缔组织病-间质性肺病（CTD-ILD）中的变化及意义。方法 选取经临床确诊的结缔组织病患者157例，其中经 肺部高分辨率CT（HRCT）确诊合并ILD的患者（CTD-ILD组）87例，未合并ILD患者（CTD-非ILD组）70例，收集2组 患者的临床资料，并完善肺功能、血气分析、肺部HRCT、红细胞沉降率（ESR）、C-反应蛋白（CRP）、HA、ColⅣ、LN、 PⅢNP-P等指标，分析HA、ColⅣ、LN和PⅢNP-P在CTD-ILD病情评估中的临床意义。结果 CTD-ILD组患者血清 HA、ColⅣ水平较CTD-非ILD组患者明显升高（P＜0.05），2组患者ESR、CRP、PⅢNP-P和LN水平比较差异无统计学 意义。CTD-ILD组血清HA水平与ESR、CRP、肺泡炎症评分和临床-影像-生理评分呈正相关（rs分别为0.230、0.254、 0.497和0.267，P＜0.05），与动脉血氧分压［p（O2）］呈负相关（rs=-0.318，P＜0.01）；CTD-ILD组血清ColⅣ与肺泡炎症 评分呈正相关（rs=0.212，P＜0.05），与p（O2）呈负相关（rs=-0.327，P＜0.01）。结论 血清HA、ColⅣ水平与CTD-ILD 肺部炎症程度密切相关，对CTD-ILD有一定的预测价值，HA能作为反映CTD-ILD病情活动度的指标。

关键词: 结缔组织疾病, 肺疾病, 间质性, 透明质酸, 胶原Ⅳ型, 层黏连蛋白, 细胞外基质, Ⅲ型前胶原N端肽, 临床-影像-生理评分

Abstract: ObjectiveTo explore the significance of the serum changes of hyaluronic acid (HA), Ⅳ type collagen, (Col Ⅳ),
laminin (LN) and type Ⅲ before pre-collagen n-terminal peptide (PⅢNP-P) in connective tissue diseases-interstitial lung
disease (CTD-ILD). MethodsA total of 157 patients diagnosed as connective tissue disease were selected, including 87
patients with the lung high-resolution CT (HRCT) diagnosed with ILD (CTD-ILD group) and 70 patients without combined
ILD (CTD-non-ILD group). The clinical data and serum test results were collected in 2 groups of patients. The pulmonary
function test, blood gas analysis and lung HRCT, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), HA, Col Ⅳ,
LN, PⅢNP-P and other indicators were also collected. The clinical significance of HA, Col Ⅳ, LN and PⅢNP-P in CTD-ILD
was analyzed. Results The serum levels of HA and Col Ⅳ were significantly increased in CTD-ILD group compared with
those of the CTD-non ILD group (P＜0.05). There were no significant differences in serum ESR, CRP, PⅢNP-P and LN
between the 2 groups of patients. The serum level of HA was positively correlated with ESR, CRP, alveolar inflammation
score and clinical-radio-physiological score in CTD-ILD group (rs= 0.230, 0.254, 0.497 and 0.267, P＜0.05), and
negatively correlated with arterial oxygen partial pressure [p（O2）] (rs=-0.318, P＜0.01). The serum level of Col Ⅳ was
positively correlated with alveolar inflammation score in CTD-ILD group (rs=0.212, P＜0.05), and negatively correlated
with p(O2) (rs=-0.327, P＜0.01). ConclusionThe serum levels of HA and Col Ⅳ are closely related to the degree of lung
inflammation of CTD - ILD, suggesting its predictive value for CTD-ILD. HA is closely associated with the condition of
CTD-ILD activity, which can be used as an indicator to reflect the disease activity of CTD-ILD.

Key words: connective tissue diseases, lung diseases, interstitial, hyaluronic acid, collagen type Ⅳ , laminin, extracellular matrix, collagen type Ⅲ before n-terminal peptide, clinical radiographic physiologic score