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目的分析皮肌炎患者外周血急性时相反应物(APR)水平与白介素(IL)-6、疾病活动度的相关性。方法采用化学发光法检测31例皮肌炎患者外周血APR(C反应蛋白、血清淀粉样蛋白A及血清铁蛋白)水平,与23例系统性红斑狼疮、22例类风湿关节炎、18例原发性干燥综合征患者相关APR水平对比,并分析皮肌炎患者APR与外周血IL-6的相关性;采用肌炎活动性评价工具评价皮肌炎患者的临床病情指标,分析其与外周血APR的相关性。结果皮肌炎患者外周血C反应蛋白〔(17.08±17.18)mg/L〕低于类风湿关节炎患者〔(85.95±60.62)mg/L,P<0.000 1〕、系统性红斑狼疮患者〔(51.34±52.98)mg/L,P=0.006〕及原发性干燥综合征患者〔(47.00±47.24)mg/L,P=0.018〕。皮肌炎患者血清淀粉样蛋白A〔(92.04±98.93)mg/L〕低于类风湿关节炎〔(311.30±292.45)mg/L,P=0.002〕及原发性干燥综合征患者〔(284.31±325.30)mg/L,P=0.025〕,血清铁蛋白〔(510.10±610.73)ng/mL〕高于原发性干燥综合征患者〔(220.33±164.07)ng/mL,P=0.02〕,略高于类风湿关节炎及系统性红斑狼疮患者,但差异无统计学意义。上述APR水平均与外周血IL-6水平呈正相关,C反应蛋白及血清铁蛋白分别仅与疾病活动性评估指标中的一般情况及肺部表现相关,与其他各系统及整体病情活动无关。结论皮肌炎患者APR增高水平低于其他常见结缔组织病,与IL-6相关,与疾病整体活动性无相关性。
Objective To analyze the correlation between peripheral blood acute phase response (APR) levels and interleukin (IL) -6, disease activity in patients with dermatomyositis. Methods The levels of APR (C-reactive protein, serum amyloid A and serum ferritin) in peripheral blood of 31 patients with dermatomyositis were detected by chemiluminescence. Twenty-three patients with systemic lupus erythematosus, 22 rheumatoid arthritis, The relative APR levels in patients with Sjogren’s syndrome were compared, and the correlation between APR and peripheral blood IL-6 in patients with dermatomyositis was analyzed. The clinical parameters of patients with dermatomyositis were evaluated by using myositis activity evaluation tools, APR relevance. Results The serum level of C-reactive protein (17.08 ± 17.18 mg / L) in patients with dermatomyositis was lower than that in patients with rheumatoid arthritis (85.95 ± 60.62 mg / L, P 0.0001) and that of patients with systemic lupus erythematosus 51.34 ± 52.98) mg / L, P = 0.006), and patients with primary Sjogren’s syndrome (47.00 ± 47.24 mg / L, P = 0.018). Patients with dermatomyositis had lower serum amyloid A (92.04 ± 98.93) mg / L than those with rheumatoid arthritis 〔(311.30 ± 292.45) mg / L, P = 0.002〕 and patients with Sj (284.31 (510.10 ± 610.73) ng / mL] was higher than that of patients with SJ [(220.33 ± 164.07) ng / mL, P = 0.02] Higher than rheumatoid arthritis and systemic lupus erythematosus patients, but the difference was not statistically significant. The levels of APR were positively correlated with the levels of IL-6 in peripheral blood. C-reactive protein and serum ferritin were only related to the general and pulmonary manifestations of disease activity assessment index, respectively, but not to other systems and overall disease activity. Conclusion The elevated level of APR in patients with dermatomyositis is lower than that of other common connective tissue diseases and is associated with IL-6, and has no correlation with the overall activity of the disease.