抗中性粒細(xì)胞胞漿抗體相關(guān)性小血管炎患者血清炎性因子與visfatin的表達(dá)
發(fā)布時(shí)間：2018-07-26 15:34
【摘要】：目的：(1)探討抗中性粒細(xì)胞胞漿抗體(ANCA)及其靶抗原蛋白酶3(PR3)和髓過(guò)氧化物酶(MPO)的檢測(cè)對(duì)ANCA相關(guān)性小血管炎(AASV)的應(yīng)用價(jià)值；(2)觀察AASV患者在小血管炎癥活動(dòng)期,血清炎性因子C反應(yīng)蛋白(CRP)、白細(xì)胞介素6(IL-6)、腫瘤壞死因子(TNF-α)和內(nèi)臟脂肪素(visfatin)的濃度變化及緩解期走向；(3)分析主要由內(nèi)臟脂肪分泌的visfatin在AASV炎性損傷和免疫調(diào)控方面的作用,及其與CRP、IL-6、TNF-α間的潛在關(guān)聯(lián)。 方法：對(duì)52例AASV活動(dòng)期與25例緩解期血清樣本采用間接免疫熒光法檢測(cè)ANCA,依據(jù)熒光顯微鏡下免疫熒光的著染部位不同分為胞漿型ANCA(cANCA)和核周型ANCA(pANCA);應(yīng)用酶聯(lián)免疫吸附法測(cè)量PR3、MPO、 IL-6、TNF-α及visfatin;免疫比濁法測(cè)定CRP含量。 結(jié)果：(1) cANCA與pANCA各自識(shí)別對(duì)應(yīng)的靶抗原PR3和MPO,具有靶抗原特異性(P0.001),且較長(zhǎng)時(shí)間內(nèi)不隨疾病的轉(zhuǎn)歸而改變(P0.05)。(2)AASV活動(dòng)期CRP、IL-6、TNF-α、visfatin水平較正常對(duì)照組均升高(P0.001)；活動(dòng)期與緩解期比較CRP(P0.05)、IL-6(P0.001)含量不同程度下降；TNF-α沒(méi)有明顯降低(P0.05)；而AASV緩解期visfatin含量較治療前仍繼續(xù)升高(P0.05)。緩解期與對(duì)照組比較CRP(P0.001)、TNF-α(P0.05)、visfatin(P0.001)仍有差異,但I(xiàn)L-6已接近正常對(duì)照組(P0.05)。(3) AASV患者各炎性因子間均呈正相關(guān)性,CRP與IL-6間的相關(guān)系數(shù)為0.471(P0.001), CRP與TNF-α間的相關(guān)系數(shù)為0.315(P0.05), CRP與visfatin間的相關(guān)系數(shù)為0.364(P0.01), IL-6與TNF-α司的相關(guān)系數(shù)性為0.458(P0.01), IL-6與visfatin間的相關(guān)系數(shù)為0.577(P0.001),TNF-α與visfatin間的相關(guān)系數(shù)為0.550(P0.001)。 結(jié)論：ANCA及其靶抗原PR3和MPO的檢測(cè)具有重要的疾病診斷價(jià)值,但由于其在體內(nèi)濃度維持時(shí)間較長(zhǎng),不能用ANCA及其靶抗原水平來(lái)預(yù)知血管炎的活動(dòng)性、治療效果、緩解和/或已經(jīng)復(fù)發(fā)。數(shù)據(jù)顯示,AASV活動(dòng)期與對(duì)照組比較,血清炎性因子CRP、IL-6、 TNF-α和visfatin濃度顯著升高,且各炎性因子和visfatin間存在正相關(guān)調(diào)控關(guān)系。在緩解期CRP、IL-6、出現(xiàn)不同程度的下調(diào),而TNF-α含量回落不明顯,緩解期血清visfatin的含量較活動(dòng)期仍有所升高,提示visfatin和TNF-α之間存在互為調(diào)控的劑量依賴關(guān)系,visfatin的這一變化可能也預(yù)示著AASV這一慢性消耗性疾病在維持緩解期內(nèi)臟脂肪細(xì)胞的緩慢修復(fù),對(duì)延長(zhǎng)患者的中性粒細(xì)胞的生存時(shí)間起作用。
[Abstract]:Objective: (1) to investigate the value of detection of anti-neutrophil cytoplasmic antibody (ANCA) and its target antigen protease 3 (PR3) and myeloperoxidase (MPO) in (AASV) of ANCA associated vasculitis. The changes of serum inflammatory factor C reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor 偽 (TNF- 偽) and visceral lipoprotein (visfatin) and the tendency of remission were analyzed. (3) the role of visfatin, mainly secreted by visceral fat, in the inflammatory injury and immune regulation of AASV was analyzed. And its potential association with CRP IL-6 TNF- 偽. Methods: the serum samples of 52 patients with active AASV and 25 patients with remission were detected by indirect immunofluorescence method. According to the location of immunofluorescence staining under fluorescence microscope, they were divided into cytoplasmic ANCA (cANCA) and perinuclear ANCA (pANCA); using enzyme-linked immunosorbent assay (Elisa). The levels of PR3 MPO, IL 6 TNF- 偽 and visfatin were measured by immunoturbidimetric method. The content of CRP was determined by immunoturbidimetric method. Results: (1) cANCA and pANCA recognized the corresponding target antigens PR3 and MPO respectively, which had target antigen specificity (P0.001), and did not change with the outcome of the disease for a long time (P0.05). (2). The level of AASV IL-6TNF- 偽 visfatin in active phase of AASV was higher than that in normal control group (P0.001). The content of CRP (P0.05) IL-6 (P0.001) did not decrease significantly (P0.05) in active phase and remission period (P0.05), while the content of visfatin in remission period of AASV was still higher than that before treatment (P0.05). The difference of CRP (P0.001) TNF- 偽 (P0.05) and visfatin (P0.001) between the remission stage and the control group was also found. But IL-6 was close to the normal control group (P0.05). (3). The correlation coefficient between AASV and IL-6 was 0.471 (P0. 001), CRP and TNF- 偽 was 0.315) (P0.05 between), CRP and visfatin was 0.364 (P0.01), and between IL-6 and TNF- 偽 was 0.364 (P0. 01). The correlation coefficient between IL-6 and TNF- 偽 was 0.471 (P0. 001) between), CRP and TNF- 偽 (P0. 05). The correlation coefficient between IL-6 and TNF- 偽 was 0.364 (P0. 01). The correlation coefficient between IL-6 and visfatin was 0.577 (P0.001) and the correlation coefficient between TNF- 偽 and visfatin was 0.550 (P0.001). Conclusion the detection of PR3 and MPO is of great value in the diagnosis of vasculitis. However, because of the long duration of concentration in vivo, the level of ANCA and its target antigen can not be used to predict the activity and therapeutic effect of vasculitis. Remission and / or recurrence. The data showed that the concentrations of serum inflammatory cytokines CRP- 6, TNF- 偽 and visfatin were significantly higher in the active period of AASV than in the control group, and there was a positive correlation between the inflammatory factors and visfatin. In the remission phase, the levels of serum visfatin were decreased in different degrees, but the content of TNF- 偽 was not significantly decreased, and the level of serum visfatin in the remission phase was still higher than that in the active phase. These results suggest that there is a dose-dependent relationship between visfatin and TNF- 偽, and this change of visfatin may also indicate the slow repair of visceral adipocytes in AASV, a chronic expendable disease, during the maintenance period of remission. It can prolong the survival time of neutrophils in patients.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R392
[Abstract]:Objective: (1) to investigate the value of detection of anti-neutrophil cytoplasmic antibody (ANCA) and its target antigen protease 3 (PR3) and myeloperoxidase (MPO) in (AASV) of ANCA associated vasculitis. The changes of serum inflammatory factor C reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor 偽 (TNF- 偽) and visceral lipoprotein (visfatin) and the tendency of remission were analyzed. (3) the role of visfatin, mainly secreted by visceral fat, in the inflammatory injury and immune regulation of AASV was analyzed. And its potential association with CRP IL-6 TNF- 偽. Methods: the serum samples of 52 patients with active AASV and 25 patients with remission were detected by indirect immunofluorescence method. According to the location of immunofluorescence staining under fluorescence microscope, they were divided into cytoplasmic ANCA (cANCA) and perinuclear ANCA (pANCA); using enzyme-linked immunosorbent assay (Elisa). The levels of PR3 MPO, IL 6 TNF- 偽 and visfatin were measured by immunoturbidimetric method. The content of CRP was determined by immunoturbidimetric method. Results: (1) cANCA and pANCA recognized the corresponding target antigens PR3 and MPO respectively, which had target antigen specificity (P0.001), and did not change with the outcome of the disease for a long time (P0.05). (2). The level of AASV IL-6TNF- 偽 visfatin in active phase of AASV was higher than that in normal control group (P0.001). The content of CRP (P0.05) IL-6 (P0.001) did not decrease significantly (P0.05) in active phase and remission period (P0.05), while the content of visfatin in remission period of AASV was still higher than that before treatment (P0.05). The difference of CRP (P0.001) TNF- 偽 (P0.05) and visfatin (P0.001) between the remission stage and the control group was also found. But IL-6 was close to the normal control group (P0.05). (3). The correlation coefficient between AASV and IL-6 was 0.471 (P0. 001), CRP and TNF- 偽 was 0.315) (P0.05 between), CRP and visfatin was 0.364 (P0.01), and between IL-6 and TNF- 偽 was 0.364 (P0. 01). The correlation coefficient between IL-6 and TNF- 偽 was 0.471 (P0. 001) between), CRP and TNF- 偽 (P0. 05). The correlation coefficient between IL-6 and TNF- 偽 was 0.364 (P0. 01). The correlation coefficient between IL-6 and visfatin was 0.577 (P0.001) and the correlation coefficient between TNF- 偽 and visfatin was 0.550 (P0.001). Conclusion the detection of PR3 and MPO is of great value in the diagnosis of vasculitis. However, because of the long duration of concentration in vivo, the level of ANCA and its target antigen can not be used to predict the activity and therapeutic effect of vasculitis. Remission and / or recurrence. The data showed that the concentrations of serum inflammatory cytokines CRP- 6, TNF- 偽 and visfatin were significantly higher in the active period of AASV than in the control group, and there was a positive correlation between the inflammatory factors and visfatin. In the remission phase, the levels of serum visfatin were decreased in different degrees, but the content of TNF- 偽 was not significantly decreased, and the level of serum visfatin in the remission phase was still higher than that in the active phase. These results suggest that there is a dose-dependent relationship between visfatin and TNF- 偽, and this change of visfatin may also indicate the slow repair of visceral adipocytes in AASV, a chronic expendable disease, during the maintenance period of remission. It can prolong the survival time of neutrophils in patients.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R392
【相似文獻(xiàn)】
相關(guān)期刊論文 前10條
1 魏日胞!100036北京,劉景鐸!100036北京,鄧世芬!100036北京;抗中性粒細(xì)胞胞漿抗體相關(guān)小血管炎并發(fā)隱性甲狀腺機(jī)能減退一例[J];中華醫(yī)學(xué)雜志;2000年11期
2 金江;朱秀麗;刁玉巧;陳健;劉翠平;趙孝先;江蓮;曲凡;;抗中性粒細(xì)胞胞漿抗體相關(guān)性小血管炎合并重度貧血1例[J];中國(guó)小兒血液與腫瘤雜志;2008年01期
3 胡偉新;如何提高小血管炎腎損害的遠(yuǎn)期預(yù)后[J];腎臟病與透析腎移植雜志;2004年06期
4 劉春蓓,胡偉新;系統(tǒng)性小血管炎的分類[J];腎臟病與透析腎移植雜志;2005年05期
5 ;抗中性粒細(xì)胞胞漿抗體相關(guān)性小血管炎治療復(fù)發(fā)和抵抗的預(yù)測(cè)指標(biāo)[J];中華醫(yī)學(xué)信息導(dǎo)報(bào);2006年01期
6 高震;李貴森;;不同劑量雷公藤多甙治療小血管炎合并蛋白尿的臨床觀察[J];醫(yī)學(xué)信息;2010年04期
7 林箐;丁磊;宋以信;;高齡老年ANCA相關(guān)性小血管炎致肺損害1例[J];中華老年多器官疾病雜志;2011年03期
8 楊光;胡偉新;;抗中性粒細(xì)胞胞漿抗體相關(guān)性血管炎的治療[J];腎臟病與透析腎移植雜志;2005年06期
9 盧樂(lè);田云龍;;丙基硫氧嘧啶導(dǎo)致抗中性粒細(xì)胞胞漿抗體陽(yáng)性小血管炎2例[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2006年02期
10 劉敏燕;白勝利;劉芳;劉先蓉;;ANCA相關(guān)性小血管炎的臨床表現(xiàn)特點(diǎn)及誤診分析[J];華西醫(yī)學(xué);2007年02期
相關(guān)會(huì)議論文 前10條
1 高瑩;陳e，
本文編號(hào)：2146472
本文鏈接：http://sikaile.net/xiyixuelunwen/2146472.html
最近更新
教材專著
