PTX3在系统性硬化症患者中表达及血管病变中的意义

发布时间：2018-05-07 07:40

本文选题：系统性硬化症 + PTX3　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:探讨血清正五聚蛋白3(pentraxin3,PTX3)水平在系统性硬化症(systemic sclerosis,SSc)患者血管病变中的意义。方法:1选取住院初治SSc患者37例作为实验组,年龄及性别相匹配的健康人31例作为对照组。按皮肤受累程度将患者分为弥漫性硬皮病(diffuse systemic sclerosis,dSSc)组(n=6)及局限性硬皮病(limited systemic sclerosis,1SSc)组(n=31)。按2016年欧洲抗风湿病联盟硬皮病试验研究组(EULAR Scleroderma Trials and Research group,EUSTAR)对SSc患者病情活动程度的修正参数(revised index)分为非活动组(revised index≤2.5,n=ll)和活动组(revisedindex2.5,n=26)。按SSc患者病程分为早期组(病程≤3年,n=23)及晚期组(病程3年,n=14)。按患者有无肢端溃疡及肺动脉高压,分为无肢端溃疡(digital ulcer,DU)组(n=30)和DU组(n=7);无肺动脉高压(pulmonary arterial hypertension,PAH)组(n=28)和 PAH 组(n=9)。2 采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测血清PTX3及成纤维细胞生长因子2(fibroblast growth factor 2,FGF2)水平。应用改良Rodnan皮肤评分(modified Rodnan skin score,mRss)等级标准对所有SSc患者皮肤变厚程度进行打分,记录改良后皮肤总分(total skin score,TSS)。所有患者接受甲襞微循环检查,记录甲襞微循环总积分(nilfold capillary total score,NCTS)。3记录SSc患者一般情况、体重指数(body mass index,BMI)、临床表现、实验室指标及其他辅助检查结果。比较各组间血清PTX3、FGF2水平差异,并与临床及实验室各项指标进行相关性分析。结果:1SSc组血清PTX3及FGF2水平均高于健康对照组(P0.05),不同病程间比较无统计学差异(P0.05)。2 dSSc与1SSc组血清PTX3及FGF2水平比较无统计学差异(P0.05)。3 SSc疾病活动组PTX3水平显著高于非活动组和健康对照组(P0.05);而活动组FGF2水平仅高于健康对照组(P0.05),与非活动组比较无统计学差异。4SSc疾病DU组PTX3、PTX3/FGF2水平均显著高于无DU组(P0.05);FGF2水平差异无统计学意义(P0.05)。5SSc疾病PAH组PTX3、PTX3/FGF2水平均高于无PAH组(P0.05);FGF2水平无统计学差异(P0.05)。6 SSc组有肺间质病变、低一氧化碳弥散量百分比(percentage diffusion capacity for carbon monoxide,DLCO%)、低高密度脂蛋白(high density lipoprotein,HDL)、高胆固醇(cholesterol,CHOL)及高低密度脂蛋白(low density lipoprotein,LDL)的患者血清PTX3 明显升高(P0.05)。7 SSc组血清PTX3水平与TSS、NCTS、CHOL、LDL呈正相关(P0.01),与DLCO%负相关(P0.05);FGF2水平与DLCO%呈负相关(P0.05)。8 Logistic回归分析结果提示PTX3/FGF2、LDL升高的SSc患者更易出现PAH(P=0.043,OR=1.028;P=0.025,OR=1.122)。结论:1 SSc患者血清PTX3水平在疾病活动判断方面呈有一定临床意义。2 PTX3可能通过抑制FGF2促进内皮细胞迁移及血管形成等功能参与SSc血管病变过程,二者比值的失衡或许有助于预测患者将来是否发生DU 和(或)PAH。3血清PTX3水平升高的SSc患者可能更容易并发动脉粥样硬化。4 PTX3、FGF2可能均参与了 SSc患者皮肤和(或)肺脏纤维化过程。5 PTX3/FGF2、LDL可能是SSc患者合并PAH的独立危险因素。
[Abstract]:Objective: To explore the significance of serum positive five polyprotein 3 (pentraxin3, PTX3) level in patients with systemic sclerosis (systemic sclerosis, SSc). Methods: 1 select 37 cases of early hospitalized SSc patients as experimental group, and 31 healthy persons with matched age and sex as the control group. Diffuse systemic sclerosis (dSSc) group (n=6) and localized scleroderma (limited systemic sclerosis, 1SSc) group (n=31). According to the 2016 European Union hard skin disease test group of scleroderma (EULAR Scleroderma), the modified parameters of the degree of activity of the patients were divided into inactive groups Vised index < 2.5, n=ll) and active group (revisedindex2.5, n=26). According to the course of SSc patients, they were divided into early group (course of disease < 3 years, n=23) and late group (course of disease 3 years, n=14). The PAH group (n=28) and group PAH (n=9).2 were used to detect the level of serum PTX3 and fibroblast growth factor 2 by enzyme linked immunosorbent assay (enzyme linked immunosorbent assay, ELISA). The total score (total skin score, TSS) was recorded. All patients received nailfold microcirculation, and the total score of nailfold microcirculation (nilfold capillary total score, NCTS).3 recorded the general condition of the SSc patients, body mass index (body), clinical manifestations, laboratory indicators and other auxiliary examination results. The serum levels of PTX3 and FGF2 were different and correlated with the clinical and laboratory indexes. Results: the serum levels of PTX3 and FGF2 in the 1SSc group were higher than those in the healthy control group (P0.05), and there was no statistical difference between the different course of disease (P0.05) and there was no statistical difference between the.2 dSSc and the 1SSc group, and there was no statistical difference between the PTX3 and the FGF2 level. The level of PTX3 was significantly higher than that in the non active group and the healthy control group (P0.05), while the FGF2 level in the active group was only higher than that in the healthy control group (P0.05), but there was no statistical difference between the non active group and the non active group. The level of PTX3/FGF2 in the DU group of.4SSc disease was significantly higher than that in the non DU group (P0.05), and the FGF2 level difference was not statistically significant (P0.05). The level of FGF2 was not statistically significant (P0.05), and there was no statistical difference in FGF2 (P0.05) in group.6 SSc with pulmonary interstitial lesions, the percentage of low carbon monoxide dispersion (percentage diffusion capacity for carbon monoxide), low density lipoprotein, high density lipoprotein and high and low density lipoprotein (high-density lipoprotein) The serum level of PTX3 in patients with lipoprotein, LDL (P0.05) was positively correlated with TSS, NCTS, CHOL, LDL, and negative correlation with TSS, NCTS, CHOL, LDL. Conclusion: the level of serum PTX3 in 1 SSc patients has certain clinical significance in judging the activity of disease..2 PTX3 may participate in the process of SSc vascular lesions by inhibiting FGF2 to promote endothelial cell migration and angiogenesis. The imbalance of the ratio of the two may be helpful to predict whether the patients' DU and / or PAH.3 serum PTX3 level increases in the future of S. Sc patients may be more likely to be associated with atherosclerotic.4 PTX3, and FGF2 may be involved in.5 PTX3/FGF2 in the skin and / or pulmonary fibrosis of SSc patients, and LDL may be an independent risk factor for PAH in patients with SSc.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.2

【参考文献】