弥漫性结缔组织病相关肺动脉高压与炎症和自身抗体关系研究

摘要

Objective:To investigate the prevalence of pulmonary arterial hypertension associated with diffuse connective tissue disease and its relationship with inflammation and autoimmune antibodies. Methods:Patients with diffuse connective tissue disease were under color doppler ultrasound pulmonary artery pressure testing,observing the erythrocyte sedimentation rate,C-reactive protein inflammatory index,and its antibody ANA and ENA antibody spectrum.Results:The prevalence of pulmonary arterial hypertension associated with diffuse connective tissue disease was 19.78% (18/91);comparing the erythrocyte sedimentation rate of patients with pulmonary arterial hypertension associated with diffuse connective tissue disease(41.79±2.44) mm•h-1 with that of those without pulmonary arterial hypertension(49.35±5.91)mm•h-1,and the two group c-reative protein[(10.40±1.98)mg·L-1,(13.68±2.02)mg·L-1]the difference had no statistical signiifcance(P>0.05). Comparing the Scl-70 positive rate of patients with pulmonary arterial hypertension associated with diffuse connective tissue disease with that of those without pulmonary arterial hypertension,the difference had statistical significance(P < 0.05).Conclusion:The inflammatory index such as erythrocyte sedimentation rate and C-reactive protein had no obvious correlation with pulmonary arterial hypertension,which proved that the mechanism of pulmonary arterial hypertension associated with diffuse connective tissue disease was complicated,probably the co-function of multiple factors.But some autoantibodies such as Scl-70 might be relevant to pulmonary arterial hypertension associated with diffuse connective tissue disease.%目的：观察弥漫性结缔组织病相关肺动脉高压的患病率，及其与炎症和自身抗体的关系。方法：纳入观察的弥漫性结缔组织病患者，行彩色多普勒超声肺动脉压力检测，观察红细胞沉降率、C-反应蛋白炎性指标，以及自身抗体ANA、ENA抗体谱。结果：弥漫性结缔组织病相关肺动脉高压的患病率为19.78%（18/91）；弥漫性结缔组织病相关肺动脉高压组红细胞沉降率（41.79±2.44）mm·h-1与未合并肺动脉高压组红细胞沉降率（49.35±5.91） mm·h-1比较，以及两组C-反应蛋白[（10.40±1.98）mg·L-1、（13.68±2.02） mg·L-1]比较，差异均无统计学意义（P>0.05）。弥漫性结缔组织病相关肺动脉高压组Scl-70阳性率27.78%与未合并肺动脉高压组Scl-70阳性率4.11%比较，差异有统计学意义（P<0.05）。结论：炎性指标红细胞沉降率、C-反应蛋白与肺动脉高压无明显相关性，说明结缔组织病合并肺动脉高压的机制复杂，可能是多因素共同作用的结果。但某些自身抗体如Scl-70可能与弥漫性结缔组织病相关肺动脉高压相关。