| Objectives To probe into the connection between 25-hydroxy vitamin D in serum and Dermatomyositis-related interstitial lung diseases and analyze the potential immunologic mechanisms,with an aim to provide experimental gist to the prevention and cure of Dermatomyositis-related interstitial lung diseases.Methods 103 cases of Dermatomyositis diagnosed by Chengde Medical College affiliated hospital from March,2015 to February,2018 were served as surveys,and they were divided into 2 groups,case group(51 cases)and control group(52 cases)according to the results of lung CT imagines.Sex,age and clinical course of surveys were recorded.The standard percentages of vital capacity(VC),forced expiratory volume in 1 second(FEV1),maximal voluntary ventilation(MVV),total lung capacity(TLC)and diffusing lung capacity for carbon monoxide(DLCO)were examined by Master Screen Lung Function Meter.The concentration of 25-hydroxyvitamin D in serum was detected by ELSA,and ESR was performed with routine method.The contents of CRP,C3 and C4 in serum were determined by immunoturbidimetry,and Ig G,Ig M and Ig A were detected by rocket electrophoresis.Immune label technique was conducted for the detection of circulation immune complex(CIC)in serum.SPSS15.0 software was applied for statistic analysis.T test and ?2 test were used to compare averages and ratios between the 2 groups respectively,and Pearson test was performed for the correlation analysis.Double side ?=0.05 was regarded as the test standard.Results 1 The standard percentages of VC,FEV1,MVV,TLC and DLCO in case group were 70.62±9.51%,90.53±9.92%,78.73±7.74%,57.64±4.73% and 61.64±6.65% respectively,and those in control group were 94.12±9.87%,92.75±7.58%,80.17±6.54%,93.12±6.25% and 91.65±8.57% respectively.The standard percentages of VC,TLC and DLCO in case group were less than those in control group,and the differences were statistic significance(P<0.05),while there were no statistic differences(P>0.05)between case and control group in the standard percentages of FEV1 and MVV.2 The concentrations of 25-hydroxyvitamin D in serum of case and control groups were 31.33±12.39?g/ml and 56.24±14.05?g/ml respectively,and the difference was statistic significance(P<0.05).The related risk ratio to be involved with interstitial lung disease in patients with Dermatomyositis was 6.31 times in case group more than that in control group.3 Results of the correlation of 25-hydroxyvitamin D concentration with Lung functions: The relation coefficients of 25-hydroxyvitamin D with VC,TLC and DLCO were 0.520,0.804 and 0.370 respectively,P<0.05 by Pearson test.4 CRP in serum of case and control group were 10.20±1.41mg/L and 10.29±1.13mg/L respectively,and ESR of case and control group were 29.52±7.87mm/h and 32.08±5.56mm/h respectively.There were no differences about the 2 items between the 2 groups.5 The concentration of C3 and C4 in case group were 1.12±0.28g/L and 0.21±0.06g/L respectively,and those in control group were 1.17±0.13g/L and 0.21±0.07g/L respectively,there were no statistic differences between the 2 groups(P>0.05).The concentration of Ig M,Ig A and Ig G in serum of case group were 1.33±0.59g/L,2.19±0.68g/L and 18.10±3.85g/L respectively,and those in control group were 1.43±0.63g/L,2.38±0.37g/L and 11.93±3.58g/L respectively.There were no statistic differences about Ig M and Ig A(P>0.05),while the concentration of Ig G in case group was higher than that in control group,and the difference was statistic significant.The concentrations of CIC in case and control groups were 0.23±0.03g/L and 0.11±0.02g/L,and the difference was statistic significance(P<0.05).6 Analysis on the correlation of 25-hydroxyvitamin D with Ig G and CIC: The concentration of Ig G was negatively related to 25-hydroxyvitamin D concentration(P<0.05)with a relation coefficient as 0.364,and CIC was negatively related to 25-hydroxyvitamin D with a relation coefficient as 0.358.7 Analysis of the diagnosis value of 25-hydroxyvitamin D on interstitial lung disease related to Dermatomyositis.The AUC of 25-hydroxyvitamin D was 0.927,and the optimum threshold of 25-hydroxyvitamin D was 38.817?g/ml.The sensitivity and specificity of diagnosis were 93.3% and 76.7% respectively.Conclusions 1 The incidence of interstitial lung disease related to Dermatomyositis was increased with the decreasing of 25-hydroxyvitamin D.2 The immune pathologic injury caused by the deposition of CIC as a result of the increasing of Ig G might contribute to interstitial lung disease related to Dermatomyositis.3 The threshold of 25-hydroxyvitamin D for the diagnosis of interstitial lung disease related to Dermatomyositis was 38.817?g/ml.Figure5;Table9;Reference 93... |
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