1、实用医学杂志2023年第39卷第9期The Journal of Practical Medicine2023 Vol.39 No.9临 床 研 究doi：10.3969/j.issn.10065725.2023.09.015基金项目：河北省2023年度医学科学研究课题计划（编号：20231784）通信作者：佟胜全Email：类风湿关节炎合并肺间质病变患者血清ficolin3、PTX3表达及临床意义高冬梅张艳春许文静李慧心王莉佟胜全唐山市工人医院风湿免疫科（河北唐山 063000）【摘要】目的通过检测血清纤维凝胶蛋白3（ficolin3）、正五聚蛋白3（pentraxin 3，PTX3）在类风
2、湿关节炎（rheumatoid arthritis，RA）合并肺间质病变（interstitial lung disease，ILD）患者的表达水平情况，来探究其在RAILD的临床意义。方法选取2020年12月至2021年12月本院收治的65例单纯的RA患者作为RA组，70例RAILD患者作为RAILD组，80例正常体检健康者为对照组；采用酶联免疫吸附法（ELISA）检测血清ficolin3、PTX3的表达水平；Pearson法分析ficolin3、PTX3的相关性以及二者与DAS28、ESR、RF、CRP 及肺功能相关指标的相关性；绘制 ROC 曲线分析 ficolin3、PTX3 对 RA
3、ILD 的诊断价值。结果RAILD组DAS28、ESR、RF、CRP值显著高于RA组和对照组，RA组显著高于对照组（P 0.05）；RAILD组的FVC、VC、DLCO值显著低于RA组和对照组，RA组显著低于对照组（P 0.05）；RAILD组血清ficolin3的表达水平显著低于RA组和对照组，RA组表达水平显著低于对照组；RAILD组血清PTX3的表达水平显著高于RA组和对照组，RA组表达水平显著高于对照组（P 0.05）；RAILD组患者血清中ficolin3的表达水平与PTX3呈负相关关系（P 0.05）；ficolin3与DAS28、ESR、RF、CRP的值呈负相关，与FVC、VC、
4、DLCO的值呈正相关（P 0.05）；PTX3与DAS28、ESR、RF、CRP的值呈正相关，与FVC、VC、DLCO 的值呈负相关（P 0.05）；二者联合诊断RAILD的AUC高于ficolin3和PTX3单独诊断的AUC值（Z=6.787，P=0.009；Z=15.492，P 0.001）。结论RAILD患者血清中ficolin3表达水平显著降低，PTX3表达水平显著增高，二者联合对RAILD具有一定的诊断价值。【关键词】类风湿关节炎；肺间质病变；纤维凝胶蛋白3；正五聚蛋白3【中图分类号】R563Expression and clinical significance of serum
5、ficolin3 and PTX3 in patients with rheumatoid arthritis complicated with pulmonary interstitial lesionsGAO Dongmei，ZHANG Yanchun，XU Wenjing，LI Huixin，WANGLi，TONG Shengquan.Department of Rheumatology，Tangshan Workers Hospital，Tangshan 063000，ChinaCorresponding author：TONG ShengquanEmail：【Abstract】Obj
6、ectiveTo investigate the expression of serum ficolin3 and pentraxin 3（PTX3）in patientswith rheumatoid arthritis combined with lung interstitial disease（RAILD）.MethodsFrom December 2020 toDecember 2021，65 rheumatoid arthritis（RA）patients in our hospital were enrolled as RA group；70 RAILD patients as
7、RAILD group，and 80 healthy subjects as control group.Enzymelinked immunosorbent assay（ELISA）was used to detect the expression level of serum ficolin3 and PTX3；Pearson method was used to analyze the correlation of ficolin3 and PTX3 and their correlation with DAS28，ESR，RF，CRP and pulmonary functionrel
8、ated indexes；ROC curve was drawn to analyze the diagnostic value of ficolin3 and PTX3 in RAILD.ResultsThe value of DAS28，ESR，RF and CRP in RAILD group was significantly higher than those in RA group and controlgroup，and significant higher value was observed in RA group when compared with the control
9、 group（P 0.05）.The value of FVC，VC and DLCO in RAILD group was significantly lower than that in RA group and the controlgroup，and significant lower value was found in the RA group when compared with the control group（P 0.05）.The expression level of serum ficolin3 in RAILD group was significantly low
10、er than that in RA group and controlgroup，and the expression level in RA group was significantly lower than that in the control group.The expressionlevel of serum PTX3 in RAILD group was the highest，followed by RA group and the control group（P 0.05）.Correlation analysis showed that the expression le
11、vel of ficolin3 in serum of patients in RAILD group was negative1148实用医学杂志2023年第39卷第9期The Journal of Practical Medicine2023 Vol.39 No.9ly correlated with PTX3（P 0.05）；ficolin3 was negatively correlated with the value of DAS28，ESR，RF andCRP，and positively with the value of FVC，VC and DLCO（P 0.05）；PTX
12、3 was positively correlated with thevalue of DAS28，ESR，RF and CRP，and negatively with the value of FVC，VC and DLCO（P 0.05）.The AUCof the combined diagnosis for RAILD with ficolin3 and PTX3 was higher than that of ficolin3 or PTX3 alone（Z=6.787，P=0.009；Z=15.492，P 0.05），具有可比性，见表1。1.2方法1.2.1实验检查指标以及28个
13、关节疾病活动度评分（DAS28）检 测 实 验 指 标：红 细 胞 沉 降 率（ESR）、类风湿因子（RF）和 C 反应蛋白（CRP）；DAS28 评分=0.56 （压痛关节数）0.28 （肿胀关节数）0.70 In（ESR）0.014（患者健康 状 况 评 分）10；用 力 肺 活 量（FVC）、肺 活 量（VC）、肺一氧化碳弥散量（DLCO）。1.2.2血清ficolin3、PTX3水平检测RA和RAILD组两组患者于入院后第二天清晨，对照组健康体检者于体检当天清晨分别取其静脉血5 mL，离心，分离上清，将血清于-80 储存，避免反复冻融影响实验。采用酶联免疫吸附法（ELISA）检测血清f
14、icolin3、PTX3水平，试剂购自美国Sigma公司，严格按照说明书步骤进行。1.3统计学方法本研究数据处理使用 SPSS25.0 软件完成。计量数据用均数 标准差表示，两组比较采用独立样本t检验分析；3组间的比较组别对照组RA组RAILD组F值P值例数806570男/女（例）46/3434/3137/330.4920.782年龄（岁）40.50 7.5040.50 8.5041.00 8.000.0930.911病程（年）6.25 1.266.02 2.566.45 1.650.9020.407表13组一般资料比较Tab.1Comparison of the three groups o
15、f general dataxs1149实用医学杂志2023年第39卷第9期The Journal of Practical Medicine2023 Vol.39 No.9采用单因素方差分析，进一步两两比较采用SNKq 检验。计数资料用例表示，组间比较采用卡方检验。采用 Pearson 法分析 RAILD 患者血清 中 ficolin 3、PTX3 的 相 关 性 以 及 二 者 与DAS28、ESR、RF、CRP、FVC、VC、DLCO 等指标的相关性；ROC 曲线分析血清中 ficolin3、PTX3 对RAILD 的诊断价值，P 0.05 认为差异有统计学意义。2结果2.13 组实验室
16、指标的比较RAILD 组 DAS28、ESR、RF、CRP 值显著高于 RA 组和对照组，RA 组显著高于对照组（P 0.05）；RAILD 组的 FVC、VC、DLCO值显著低于RA组和对照组，RA组显著低于对照组（P 0.05）。见表2。2.23组血清中ficolin3、PTX3的表达水平RA组别对照组RA组RAILD组F值P值例数806570DAS28（分）2.00 0.554.75 1.21*6.00 1.54*#242.042 0.001ESR（mm/h）40.12 5.0345.13 5.12*48.40 5.23*#49.897 0.001RF（IU/mL）202.12 30.21271.42 30.15*300.76 30.27*#212.439 0.001CRP（mg/L）20.12 3.4325.64 3.38*30.12 3.65*#154.751 0.001FVC（mL）43.23 4.5335.17 4.31*25.68 4.28*#299.203 0.001VC（mL）98.14 10.0481.03 10.12*72.86 9.95*#124.817 0.
