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[1]刘 颖,梅焕平,吴云娟,等.抗内皮细胞抗体在多发性肌炎/皮肌炎合并间质性肺疾病中的应用[J].医学研究与战创伤救治(原医学研究生学报),2016,18(03):278-280,286.[doi:10.3969/j.issn.1672-271X.2016.03.017]
　LIU Ying,MEI Huan-ping,WU Yun-juan,et al.Diagnostic and monitoring significance of Anti-endothelial cell antibody in patients with polymyositis/dermatomyositis accompanied by interstitial lung diseases[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(03):278-280,286.[doi:10.3969/j.issn.1672-271X.2016.03.017]
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抗内皮细胞抗体在多发性肌炎/皮肌炎合并间质性肺疾病中的应用()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第18卷
期数:
2016年03期
页码:
278-280,286
栏目:
出版日期:
2016-06-30

文章信息/Info

Title:
Diagnostic and monitoring significance of Anti-endothelial cell antibody in patients with polymyositis/dermatomyositis accompanied by interstitial lung diseases
作者:
刘 颖; 梅焕平; 吴云娟; 张缪佳
210029江苏南京，南京医科大学第一附属医院风湿免疫科
Author(s):
LIU Ying;  MEI Huan-ping;  WU Yun-juan;  ZHANG Miu-jia.
Department of Rheumatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
关键词:
抗内皮细胞抗体; 多发性肌炎/皮肌炎; 间质性肺疾病
Keywords:
anti-endothelial cell antibody(AECA);  PM/DM;  ILD
分类号:
R563.1+3
DOI:
10.3969/j.issn.1672-271X.2016.03.017
文献标志码:
A
摘要:
目的 研究抗内皮细胞抗体(anti-endothelial cell antibody, AECA)对多发性肌炎/皮肌炎（polymyositis/dermatomyositis, PM/DM）合并间质性肺疾病（interstitial lung disease, ILD）的诊断价值及其与ILD病情活动度的关系。方法 PM/DM患者106例分为合并ILD（PM/DM-ILD）组58例和未合并ILD（PM/DM-NILD）组48例，42例健康体检者为对照组。采用间接免疫荧光法（IIF）检测患者血清中AECA，记录患者年龄、病程、白细胞计数（WBC）、中性粒细胞比值[N（%）]、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、C反应蛋白(CRP)、血沉(ESR)、免疫球蛋白G(IgG)及其他临床资料。结果 ① PM/DM-ILD组、PM/DM-NILD组、对照组AECA阳性率分别为62.07%、33.33%、9.52%；前两组与对照组相比，阳性率差异有统计学意义，PM/DM-ILD组与PM/DM-NILD组相比，差异亦有统计学意义。② 比较PM/DM-ILD组和PM/DM-NILD组的其他各项指标，差异无统计学意义，仅中性粒细胞比值差异有统计学意义（P<0.05）。③ 根据胸部高分辨CT及临床表现将58例PM/DM-ILD患者分为活动期组（40例）和稳定期组（18例），两组AECA阳性率分别为80.00%、22.22%，差异有统计学意义（P<0.05）。④ AECA用于PM/DM诊断的敏感性为49.06%，特异性为90.48%，阳性预测值为92.86%，阴性预测值为41.30%。用于PM/DM-ILD诊断敏感性为62.07%，特异性为77.78%，阳性预测值为64.29%，阴性预测值为76.09%。结论 在PM/DM患者血清中检测出AECA反映ILD炎性活动，有助于PM/DM-ILD的诊断和鉴别诊断。
Abstract:
Objective To identify the diagnostic value of Anti-endothelial cell antibody(AECA) and the association with disease activity. Methods One hundred and six patients with PM/DM were assigned into two groups of PM/DM-ILD (with ILD,58 cases) and PM/DM-NILD (without ILD,48 cases). Another 42 healthy people were taken as the control (HC). Serum AECA collected from these patients were tested by indirect immunofluorescence (IIF). We reviewed patient clinical details such as age, and duration as well as laboratory data of WBC, N (%), ALT, AST, LDH, CK, CRP and ESR. Results ① The positive rate of AECA in PM/DM-ILD, PM/DM-NILD and HC was 62.07%, 33.33% and 9.52% respectively. The former two groups showed significant difference compared with HC (PM/DM-ILD: χ2=28.02, P=0.000; PM/DM-NILD; χ2=7.35, P=0.007). Furthermore, the group of PM/DM-ILD got a significant higher positive rate than the PM/DM-NILD group (χ2=8.68, P =0.003). ② There was a higher level of N% in PM/DM-ILD group compared with the PM/DM-NILD group. All other clinical features were similar. ③ 58 patients were then divided into active group (40 cases) and stable group (18 cases) according to HRCT and clinical manifestation. The active group took a significant higher prevalence of AECA than the stable one (80.00% versus 22.22%, χ2=17.60, P<0.05). ④ The sensitivity, specificity, positive predictive value and negative predictive value for AECA to diagnose PM/DM were 49.06%, 90.48%, 92.86% and 41.30%. In aspect of PM/DM-ILD, the four diagnostic value were 62.07%, 77.78%, 64.29% and 76.09%, respectively. Conclusion The identification of serum AECA in PM/DM patients reflected the activity of ILD to some extent and plays a useful part in diagnosing and differential diagnosing of PM/DM-ILD.

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备注/Memo

备注/Memo:
重点病种规范化诊疗研究（BL20130134）
更新日期/Last Update: 2016-05-20