本文選題：IgG　切入點(diǎn)：IgG相關(guān)性疾病　出處：《北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年06期 　論文類型：期刊論文

【摘要】：目的:探討血清IgG4在不同疾病患者中的表達(dá),以及其在IgG4相關(guān)性疾病患者治療前后的變化和臨床意義。方法:選擇北京大學(xué)人民醫(yī)院2015年1月1日至2016年3月31日就診患者中進(jìn)行血清IgG4檢驗(yàn)的620例患者為研究對(duì)象進(jìn)行回顧性分析,按照病種的不同分為普通疾病組、自身免疫性疾病組及IgG4相關(guān)性疾病組;胰腺疾病患者分為自身免疫性胰腺炎組及胰腺癌組;按照疾病治療階段不同將IgG4相關(guān)性疾病患者再分為治療前組及治療后組;分別分析對(duì)比各組患者血清IgG4的表達(dá)。結(jié)果:普通疾病組的患者血清IgG4水平中位數(shù)為0.480(0.005,50.400)g/L,自身免疫性疾病組患者血清IgG4水平中位數(shù)為0.406(0.003,18.700)g/L,IgG4相關(guān)性疾病組患者血清IgG4水平中位數(shù)為5.200(0.046,46.000)g/L,明顯高于普通疾病組及自身免疫性疾病組,與該兩組患者血清IgG4水平差異有統(tǒng)計(jì)學(xué)意義(P0.01),普通疾病組與自身免疫性疾病組患者血清IgG4水平相比,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。胰腺疾病患者中,自身免疫性胰腺炎組患者血清IgG4水平中位數(shù)為3.735(0.063,46.000)g/L,胰腺癌組患者血清IgG4水平中位數(shù)為0.438(0.056,1.130)g/L,自身免疫性胰腺炎組患者血清IgG4水平高于胰腺癌組,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。在IgG4相關(guān)性疾病患者中,治療前患者組血清IgG4水平中位數(shù)為6.540(1.330,34.100)g/L,治療后患者組血清IgG4水平中位數(shù)為3.705(0.208,30.200)g/L,血清IgG4水平在患者治療后下降,低于治療前水平,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論:不同疾病類型的患者血清IgG4表達(dá)不同,在自身免疫性胰腺炎及IgG4相關(guān)性疾病中,患者血清IgG4表達(dá)明顯升高,通過檢測患者血清IgG4水平的高低,可以為不同疾病的鑒別診斷提供依據(jù);在IgG4相關(guān)性疾病中,血清IgG4水平在治療后表達(dá)明顯下降,血清IgG4有可能作為評(píng)估IgG4相關(guān)性疾病療效的指標(biāo)之一。
[Abstract]:Objective: to investigate the expression of serum IgG4 in patients with different diseases. The changes and clinical significance of IgG4 in patients with IgG4 associated diseases before and after treatment methods: a total of 620 patients with serum IgG4 were selected from January 1st 2015 to March 31st 2016 in Peking University Renmin Hospital. The research object carries on the retrospective analysis, Patients with pancreatic diseases were divided into three groups: common disease group, autoimmune disease group and IgG4 associated disease group, and pancreatic disease patients were divided into autoimmune pancreatitis group and pancreatic cancer group. Patients with IgG4 related diseases were subdivided into pre-treatment group and post-treatment group according to the stage of disease treatment. Results: the median level of serum IgG4 in patients with common diseases was 0.480,0.005 ~ 50.400 g / L, and the median of serum IgG4 in autoimmune diseases was 0.406 ~ 0.003 ~ 18.700 g 路L ~ (-1) L ~ (-1). Results: the median of serum IgG4 was 0.406g / L of 18.700g / L IgG4-associated diseases. The average median was 5.200 g / L of 0.046 g / L, which was significantly higher than that of the general disease group and the autoimmune disease group. There was a significant difference in serum IgG4 level between the two groups (P 0.01), but there was no significant difference in serum IgG4 level between the normal disease group and the autoimmune disease group (P 0.05). The median of serum IgG4 level in autoimmune pancreatitis group was 3.735 鹵0.063 GPA / L, and the median serum IgG4 level in pancreatic cancer group was 0.438 / 0.056 / L and 1.130 g / L, respectively. The serum IgG4 level in autoimmune pancreatitis group was higher than that in pancreatic cancer group, and the serum IgG4 level in autoimmune pancreatitis group was higher than that in pancreatic carcinoma group. In the patients with IgG4 related diseases, the median of serum IgG4 level before treatment was 6.540 / 1.330, 34.100g / L, and after treatment the median level of serum IgG4 was 3.7050.2080.200 g / L, and the level of serum IgG4 decreased after treatment, which was lower than that before treatment. Conclusion: the expression of serum IgG4 is different in patients with autoimmune pancreatitis and IgG4 related diseases. The expression of IgG4 in serum of patients with autoimmune pancreatitis and IgG4 related diseases is obviously increased. It can provide evidence for differential diagnosis of different diseases, in IgG4 related diseases, the expression of serum IgG4 decreased significantly after treatment, serum IgG4 may be one of the indicators to evaluate the curative effect of IgG4 related diseases.
【作者單位】： 北京大學(xué)人民醫(yī)院消化內(nèi)科;鄭州人民醫(yī)院消化內(nèi)科;
【分類號(hào)】：R593.2

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