【摘要】 目的探究抗中性粒细胞细胞质抗体相关性血管炎(AAV)患者血清免疫球蛋白G4(IgG4)的表达水平及临床意义。方法收集2018年4月至2020年4月重庆医科大学附属第二医院确诊的85例AAV患者血清(AAV组),其中抗髓过氧化物酶(MPO)抗体阳性AAV(MPO-AAV亚型)患者65例,抗蛋白酶3(PR3)抗体阳性AAV(PR3-AAV亚型)患者20例;收集同期到重庆医科大学附属第二医院体检的35名健康体检者血清(对照组),进行IgG4、IgG、抗MPO抗体、抗PR3抗体检测,比较AAV组、对照组、MPO-AAV亚型、PR3-AAV亚型研究对象IgG4水平和IgG4/IgG比值,并分析IgG4水平与抗MPO抗体水平、抗PR3抗体水平的相关性。结果 AAV组患者IgG4水平、IgG4/IgG比值均明显高于对照组,差异均有统计学意义(P<0.05);MPO-AAV亚型患者IgG4水平、IgG4/IgG比值与PR3-AAV亚型比较,差异均无统计学意义(P>0.05)。MPO-AAV亚型患者IgG4水平与抗MPO抗体水平呈明显正向弱相关(r=0.443,P=0.001);PR3-AAV亚型患者IgG4水平与抗PR3抗体水平无关(r=0.300,P=0.198)。结论 AAV患者血清IgG4表达水平较高,检测IgG4可辅助临床诊断AAV。更多还原

【Abstract】 Objective To study the expression level and clinical significance of serum IgG4 in the patients with antineutrophilic cytoplasmic antibody-associated vasculitis(AAV).Methods The serum samples in 85 patients with AAV definitely diagnosed in the Second Affiliated Hospital of Chongqing Medical University from April 2018 to April 2020 were collected,including 65 cases of anti-myeloperoxidase antibody positive AAV(MPO-AAV subtype)and 20 cases of anti-proteinase 3 antibody positive AAV(PR3-AAV subtype),and contemporaneous 35 serum samples from the subjects undergoing the healthy physical examination in the hospital were collected as the control group.The levels of serum IgG4,IgG,anti-MPO antibodies and anti-PR3 antibodies were tested.Then the levels of IgG4 and IgG4/IgG ratio were compared among the AAV group,control group,subjects with MPOAAV subtype and subjects with PR3-AAV subtype.Moreover the correlation between the IgG4 level with the anti-MPO antibody and anti-PR3 antibody levels was analyzed.Results The IgG4 level and IgG4/IgG ratio in the AAV group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).No statistically significant differences were found in the IgG4 levels and the IgG4/IgG ratio between the patients with MPO-AAV subtype and the patients with PR3-AAV subtype(P>0.05).The IgG4 level in the patients with MPO-AAV subtype had weakly positive correlation with the antiMPO antibody level(r=0.443,P=0.001),and the IgG4 level in the patients with PR3-AAV subtype had no the correlation with the anti-PR3 antibody level(r=0.300,P=0.198).Conclusion The serum IgG4 level in the patient with AAV is higher.The detection of IgG4 could assist the clinical diagnosis of AAV.更多还原