天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (1): 94-98.doi: 10.11958/20211691

• 应用研究 • 上一篇    下一篇

抗中性粒细胞胞浆抗体及相关实验室指标在肺纤维化患者中的应用探讨#br#

朱黎娜1，王居鹏1，宋雅琳2，封继宏2，马明坤1，温学红1△   

  1. 1天津中医药大学第二附属医院检验科（邮编300250），2呼吸科
  • 收稿日期:2021-07-20 修回日期:2021-08-24 出版日期:2022-01-15 发布日期:2022-01-19
  • 通讯作者: 温学红 E-mail:xh-wen@163.com
  • 基金资助:
    天津市高等学校创新团队培养计划（TD13-5051）

Application of antineutrophil cytoplasmic antibodies and related laboratory parameters in patients with pulmonary fibrosis

ZHU Lina1, WANG Jupeng1, SONG Yalin2, FENG Jihong2, MA Mingkun1, WEN Xuehong1△   

  1. 1 Department of Laboratory, 2 Department of Respiratory Medicine, the Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
  • Received:2021-07-20 Revised:2021-08-24 Published:2022-01-15 Online:2022-01-19

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摘要：

摘要：目的　探讨肺纤维化（PF）患者抗中性粒细胞胞浆抗体（ANCA）阳性率、核型和靶抗原情况及其与常见临床指标的关系。方法　选取诊断为PF且同时行ANCA检测的患者302例。其中72例ANCA阳性PF患者为ANCA阳性PF组；230例ANCA阴性PF患者根据随机数字表法抽取72例为ANCA阴性PF组。另外，选取25例不伴PF的ANCA阳性患者作为ANCA阳性非PF组，20例健康体检者作为健康对照组。分析各组的ANCA核型及靶抗原、炎症、凝血-纤溶、免疫功能、肾功能相关实验室指标。结果　ANCA阳性PF患者占同期PF患者的23.84%。ANCA阳性PF组核周型ANCA（pANCA）阳性比例较胞浆型ANCA（cANCA）更多，靶抗原髓过氧化物酶（MPO）阳性比例较蛋白酶3（PR3）更多。ANCA阳性PF组C反应蛋白（CRP）较ANCA阴性PF组显著升高，ANCA阳性PF组、ANCA阴性PF组、ANCA阳性非PF组的血沉（ESR）、CRP、降钙素原（PCT）、D二聚体（D-Dimer）、纤维蛋白原（FIB）较健康对照组显著升高（P＜0.008）。ANCA阳性PF组和ANCA阳性非PF组补体3（C3）较健康对照组和ANCA阴性PF组显著降低，ANCA阳性非PF组的血肌酐（Scr）较ANCA阴性PF组显著升高（P＜0.008）。结论　诊断PF时应考虑存在抗中性粒细胞胞浆抗体相关血管炎的可能，同时应重视ESR、CRP、PCT、D-dimer、FIB、C3和Scr指标的变化。

关键词: 肺纤维化, 抗中性粒细胞胞浆抗体相关性血管炎, 血沉, C反应蛋白质, 降钙素, D-二聚体

Abstract:

Abstract: Objective　To investigate the positive rate, karyotype and target antigen of antineutrophil cytoplasmic antibody (ANCA) in patients with pulmonary fibrosis (PF) and its relationship with common clinical indexes. Methods　A total of 302 patients diagnosed with PF and detected by ANCA at the same time were collected. Among them, 72 ANCA-positive patients presenting with PF were selected as the ANCA-positive PF group, and 72 ANCA-negative patients presenting with PF (n=230) were selected as the ANCA-negative PF group according to the random number table method. Twenty-five ANCA-positive patients without PF were selected as the ANCA-positive non-PF group. Twenty healthy subjects were selected as the healthy control group. Karyotype and target antigen of ANCA, data of laboratory indicators related to inflammation, coagulation - fibrinolysis, immune function and renal function were analyzed. Results　ANCA positive PF patients accounted for 23.84% of PF patients in the same period. In the ANCA positive PF group, the positive proportion of pANCA was more than that of cANCA, and the positive proportion of target antigen myeloperoxidase (MPO) was more than that of protease 3(PR3). C-reactive protein (CRP) was significantly higher in the ANCA positive PF group than that in the ANCA negative PF group. ESR, CRP, procalcitonin (PCT), D-dimer and fibrinogen (FIB) were significantly higher in the ANCA positive PF group, the ANCA negative PF group and the ANCA positive non PF group than those in the healthy control group (P＜0.008). C3 was significantly lower in the ANCA positive PF group and the ANCA positive non PF group than that in the healthy control group and the ANCA negative PF group, and serum creatinine (SCR) was significantly higher in the ANCA positive non PF group than that in the ANCA negative PF group (P＜0.008). Conclusion　The possibility of antineutrophil cytoplasmic antibodies associated vasculitis should be considered when diagnosing PF, and attention should be paid to changes of ESR, CRP, PCT, D-Dimer, FIB, C3 and Scr indicators. 

Key words: pulmonary fibrosis, anti-neutrophil cytoplasmic antibody-associated vasculitis, blood sedimentation, C-reactive protein, calcitonin, D-dimer

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