慢性主动脉周围炎患者临床特征分析及鹅脱氧胆酸在其发病机制中的临床意义
发布时间：2019-03-31 11:37
【摘要】：目的分析慢性主动脉周围炎(chronic periaortitis,CP)患者的临床特征,初步探索鹅脱氧胆酸(chenodeoxycholic acid,CDCA)在CP发病机制中的意义,为治疗该病提供新思路。方法回顾性分析2004年10月至2017年3月期间17例CP患者的临床资料。液相色谱-串联质谱法(UPLC-MS/MS)检测5例CP患者及各对照组患者血清中CDCA含量。此外,对1例活动期CP患者进行后腹膜穿刺,病理标本行免疫组化检测IL-6、巨噬细胞表面特异性标志物F4/80及法尼酯受体(farnesoid-X-receptor,FXR)表达情况。结果 17例CP患者中,男女比例为3.25∶1,平均年龄为(62.5±8.4)岁。患者的首发症状有腰痛、腹痛等。实验室检查可有血沉和C反应蛋白的升高。与各对照组患者相比,CP患者血清中CDCA含量明显降低。免疫组化结果显示,脂肪和胶原纤维组织内泡沫细胞样细胞和淋巴细胞聚集部位可见IL-6高表达,并有F4/80及FXR的表达。结论 CP是一种罕见的自身免疫性炎症性疾病,起病隐匿,临床特征各异。血清中CDCA降低可能是该疾病的新临床指标。CDCA-FXR/IL-6通路可能在CP发病中起到一定作用。
[Abstract]:Aim to analyze the clinical features of patients with chronic periaortic inflammation (chronic periaortitis,CP) and explore the significance of chenodeoxycholic acid (chenodeoxycholic acid,CDCA) in the pathogenesis of CP. Methods the clinical data of 17 patients with CP from Oct. 2004 to March 2017 were retrospectively analyzed. Serum CDCA levels were determined by liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) in 5 patients with CP and each control group. In addition, retroperitoneal puncture was performed in a patient with active CP. Immunohistochemical staining was performed to detect the expression of F4 / 80 and farnesoid-X-receptor,FXR on the surface of IL-6, macrophages. Results in 17 patients with CP, the ratio of male to female was 3.25ml and the mean age was (62.5 卤8.4) years. The first symptom of the patient is low back pain, abdominal pain and so on. Laboratory tests showed an increase in ESR and C-reactive protein. Compared with the control group, the level of CDCA in the serum of CP patients was significantly lower than that of the control group. Immunohistochemical results showed that high expression of IL-6 was observed in foam-like cells and lymphocytes in adipose tissue and collagen fiber, and F4 / 80 and FXR were also expressed in adipose tissue and collagen fiber. Conclusion CP is a rare autoimmune inflammatory disease with occult onset and different clinical features. The decrease of serum CDCA may be a new clinical marker of the disease. CDCA-FXR/IL-6 pathway may play a role in the pathogenesis of CP.
【作者单位】： 上海交通大学医学院附属仁济医院风湿免疫科;上海交通大学医学院附属新华医院神经内科;复旦大学附属中山医院风湿免疫科;
【分类号】：R543.1
，
本文编号：2450866
[Abstract]:Aim to analyze the clinical features of patients with chronic periaortic inflammation (chronic periaortitis,CP) and explore the significance of chenodeoxycholic acid (chenodeoxycholic acid,CDCA) in the pathogenesis of CP. Methods the clinical data of 17 patients with CP from Oct. 2004 to March 2017 were retrospectively analyzed. Serum CDCA levels were determined by liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) in 5 patients with CP and each control group. In addition, retroperitoneal puncture was performed in a patient with active CP. Immunohistochemical staining was performed to detect the expression of F4 / 80 and farnesoid-X-receptor,FXR on the surface of IL-6, macrophages. Results in 17 patients with CP, the ratio of male to female was 3.25ml and the mean age was (62.5 卤8.4) years. The first symptom of the patient is low back pain, abdominal pain and so on. Laboratory tests showed an increase in ESR and C-reactive protein. Compared with the control group, the level of CDCA in the serum of CP patients was significantly lower than that of the control group. Immunohistochemical results showed that high expression of IL-6 was observed in foam-like cells and lymphocytes in adipose tissue and collagen fiber, and F4 / 80 and FXR were also expressed in adipose tissue and collagen fiber. Conclusion CP is a rare autoimmune inflammatory disease with occult onset and different clinical features. The decrease of serum CDCA may be a new clinical marker of the disease. CDCA-FXR/IL-6 pathway may play a role in the pathogenesis of CP.
【作者单位】： 上海交通大学医学院附属仁济医院风湿免疫科;上海交通大学医学院附属新华医院神经内科;复旦大学附属中山医院风湿免疫科;
【分类号】：R543.1
，
本文编号：2450866
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