类风湿关节炎合并肺间质性病变病人血清YKL−40、AGE、RAGEs、MMP−7、IL−8水平及意义

刘彦洁; 李良霄; 陈庆娜; 马利娜; 肖冉冉

类风湿关节炎合并肺间质性病变病人血清YKL−40、AGE、RAGEs、MMP−7、IL−8水平及意义

Study on the serum levels of YKL-40, AGE, RAGEs, MMP-7 and IL-8 in patients with rheumatoid arthritis complicated with pulmonary interstitial lesions and their significance

摘要

摘要:
目的： 探究类风湿关节炎合并肺间质性病变（RA−ILD）病人血清人软骨糖蛋白39（YKL−40）、晚期糖基化终末产物（AGE）、AGE受体（RAGEs）、基质金属蛋白酶−7（MMP−7）、白细胞介素−8（IL−8）表达水平及临床意义。
方法： 选择100例RA−ILD病人为RA−ILD组，100例单纯RA病人作为RA组。采用酶联免疫吸附法检测血清YKL−40、AGE、RAGEs、MMP−7、IL−8及炎症指标水平，肺功能检测仪检测用力肺活量（FVC）和一氧化碳弥散量（DLCO）。
结果： RA−ILD组YKL−40、AGE、MMP−7、IL−8、IL−6、IL−17、IL−27、高迁移率族蛋白1（HMGB1）、中性粒细胞巨噬细胞集落刺激因子（GM−CSF）、类风湿因子（RF）均明显高于RA组（P ＜ 0.01），RAGEs、FVC、DLCO均明显低于RA组（P ＜ 0.01）。Pearson相关分析显示，RA−ILD病人血清YKL−40、AGE、MMP−7、IL−8水平与RF、HMGB1、IL−6、IL−17、IL−27、GM−CSF均呈明显正相关关系（P ＜ 0.01），与FVC、DLCO均呈明显负相关关系（P ＜ 0.01）；RAGEs与RF、HMGB1、IL−6、IL−17、IL−27、GM−CSF均呈明显负相关关系（P ＜ 0.01），与FVC、DLCO均呈明显正相关关系（P ＜ 0.01）。血清YKL−40、AGE、RAGEs、MMP−7、IL−8单独及各指标联合诊断RA−ILD的AUC分别为0.823、0.814、0.737、0.865、0.817、0.982。
结论： RA−ILD病人血清YKL−40、AGE、MMP−7、IL−8水平显著增高，RAGEs水平显著降低，联合检测对早期发现RA病人合并ILD可能有重要意义。

Abstract:
Objective To investigate the expression levels of serum human cartilage glycoprotein 39(YKL-40), advanced glycation end product (AGE), receptor for advanced glycation end products (RAGEs), matrix metalloproteinase 7(MMP-7), interleukin-8(IL-8) in patients with rheumatoid arthritis (RA) complicated with interstitial lung disease (ILD) (RA-ILD), and clinical significance.
Methods One hundred patients with RA-ILD and 100 RA patients were divided into the RA-ILD group and RA group. The Enzyme-linked immunosorbent assay was used to detect the levels of serum YKL-40, AGE, RAGEs, MMP-7 and IL-8, and the pulmonary function tester was used to detect the forced vital capacity (FVC) and diffusing capacity of carbon monoxide (DLCO) in two groups.
Results The levels of YKL-40, AGE, MMP-7, IL-8, HMGB1, IL-6, IL-17, IL-27, GM-CSF, rheumatoid factor (RF) in the RA-ILD group were significantly higher than those in RA group (P ＜ 0.05), the RAGEs, FVC and DLCO were greatly lower than those in RA group (P ＜ 0.05). The results of Pearson correlation analysis showed that the serum levels of YKL-40, AGE, MMP-7 and IL-8 in RA-ILD patients were significantly positively correlated with RF, HMGB1, IL-6, IL-17, IL-27 and GM-CSF (P ＜ 0.01), and negatively correlated with FVC and DLCO (P ＜ 0.01). The RAGEs were negatively correlated with RF, HMGB1, IL-6, IL-17, IL-27 and GM-CSF (P ＜ 0.01), and positively correlated with FVC and DLCO in RA-ILD patients (P ＜ 0.01). The area under the curve (AUC) of serum YKL-40, SP-A, SP-D, KL-6 and IL-8 alone, and combination with other indicators in the diagnosing of RA-ILD was 0.823, 0.814, 0.737, 0.865 and 0.817, and 0.982, respectively.
Conclusions The serum levels of YKL-40, AGE, MMP-7 and IL-8 in RA-ILD patients greatly increase, and the RAGEs level greatly decreases, and the combined detection may be of great significance for early detection of RA patients complicated with ILD.

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