【摘要】：目的分析慢性主動脈周圍炎(chronic periaortitis,CP)患者的臨床特征,初步探索鵝脫氧膽酸(chenodeoxycholic acid,CDCA)在CP發(fā)病機制中的意義,為治療該病提供新思路。方法回顧性分析2004年10月至2017年3月期間17例CP患者的臨床資料。液相色譜-串聯(lián)質(zhì)譜法(UPLC-MS/MS)檢測5例CP患者及各對照組患者血清中CDCA含量。此外,對1例活動期CP患者進(jìn)行后腹膜穿刺,病理標(biāo)本行免疫組化檢測IL-6、巨噬細(xì)胞表面特異性標(biāo)志物F4/80及法尼酯受體(farnesoid-X-receptor,FXR)表達(dá)情況。結(jié)果 17例CP患者中,男女比例為3.25∶1,平均年齡為(62.5±8.4)歲�；颊叩氖装l(fā)癥狀有腰痛、腹痛等。實驗室檢查可有血沉和C反應(yīng)蛋白的升高。與各對照組患者相比,CP患者血清中CDCA含量明顯降低。免疫組化結(jié)果顯示,脂肪和膠原纖維組織內(nèi)泡沫細(xì)胞樣細(xì)胞和淋巴細(xì)胞聚集部位可見IL-6高表達(dá),并有F4/80及FXR的表達(dá)。結(jié)論 CP是一種罕見的自身免疫性炎癥性疾病,起病隱匿,臨床特征各異。血清中CDCA降低可能是該疾病的新臨床指標(biāo)。CDCA-FXR/IL-6通路可能在CP發(fā)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 鹵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.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院風(fēng)濕免疫科;上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院神經(jīng)內(nèi)科;復(fù)旦大學(xué)附屬中山醫(yī)院風(fēng)濕免疫科;
【分類號】：R543.1
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本文編號：2450866