血清microRNA-200c 与类风湿关节炎相关 间质性肺疾病的相关性分析

Correlation between serum miR-200c and rheumatoid arthritis related interstitial lung disease

摘要:

目的 探讨血清microRNA-200c（miR-200c）对类风湿关节炎相关间质性肺疾病（RA-ILD） 的诊断价值，以及与肺功能障碍程度的相关性。方法 选取2016 年1 月—2018 年8 月在乐山市中医医院肺 病科就诊的类风湿关节炎（RA）患者87 例作为研究对象（RA 组），根据临床症状、肺部高分辨CT（HRCT） 及X 射线检查评估结果，将RA 组分为RA-ILD 组34 例及非间质性肺疾病（ILD）组53 例。另选取同期 30 例健康志愿者作为对照组。采用实时荧光定量聚合酶链反应（qRT-PCR）检测各组血清miR-200c 的表 达水平；同时进行肺功能和HRCT 检查。绘制受试者工作特征（ROC）曲线分析血清miR-200c 的诊断效 能，并采用Spearman 等级相关性曲线分析血清miR-200c 与ILD 评分的线性关系。结果 RA 组血清miR- 200c 水平高于对照组（P <0.05）；RA-ILD 组血清miR-200c 水平高于非ILD 组（P <0.05）。RA-ILD 组与 非ILD 组年龄、BMI、病程、吸烟史、肿胀关节数、压痛关节数及ILD 评分比较，差异有统计学意义（P <0.05）。 随着肺通气功能障碍和肺弥散功能障碍程度的加重，患者血清miR-200c 水平逐渐升高（P <0.05）。④ RAILD 患者血清miR-200c 水平与HRCT 检查的ILD 评分呈正相关（r s =0.889，P =0.000）。血清miR-200c 诊 断RA-ILD 的曲线下面积为0.787（95% CI ：0.687，0.887），敏感性为78.79%（95% CI ：0.734，0.792），特异 性为62.96%（95% CI ：0.601，0.684）。结论 RA-ILD 患者血清miR-200c 水平与ILD 的严重程度关系密切， 有望成为诊断RA 患者发生ILD 的客观指标。

Abstract:

Objective To investigate the diagnostic value of serum miR-200c on rheumatoid arthritis related interstitial lung disease (RA-ILD) and its relationship with the severity of interstitial lung disease. Methods From January 2016 to August 2018, 87 RA patients and 30 healthy volunteers in our hospital were enrolled into the study. There were 34 RA patients with ILD in RA-ILD group and 53 RA patients without ILD in non-ILD group. qRT-PCR was used to detected serum miR-200c. And the lung function and interstitial lung scores were detected by CT and high resolution computer tomography (HRCT), respectively. Results 1. The level of serum miR-200c of RA patients was higher than that of healthy volunteers (P < 0.05). And the level of serum miR-200c of RA-ILD patients was higher than non-ILD patients (P < 0.05). 2. There were significant differences in age, body mass index (BMI), disease duration, smoking, joint swelling and tenderness and the scores of interstitial lung disease between RA-ILD patients and non-ILD patients (P < 0.05). 3. With the aggravation of pulmonary ventilation dysfunction and pulmonary diffusion dysfunction, the level of mir-200c in patients' serum gradually increased (P < 0.05). 4. The level of serum miR-200c in RA-ILD patients was positive related with the the scores of interstitial lung disease detected by HRCT (r s = 0.889, P < 0.05). 5. According to the ROC curve analysis, the area under ROC curve of miR-200c for RA-ILD diagnosis was 0.787 (95% CI: 0.687, 0.887). And the sensitivity and specificity were 78.79% (95% CI: 0.734, 0.792) and 62.96% (95% CI: 0.601, 0.684), respectively. Conclusion The level of serum miR-200c can be helpful to judge the severity of interstitial lung disease, which may be used as the objective indexes for diagnosis of RA patients with interstitial lung disease.