不同疾病血清IgG4检测临床价值探讨.doc

不同疾病血清IgG4检测的临床价值探讨 姜玉章 刘蓓蓓 刘炎 吴建 （南京医科大学附属淮安市第一医院 223300） [摘要] 目的： 探讨血清免疫球蛋白G亚型4（IgG4）在不同疾病诊治中的价值。方法：运用免疫散射比浊法检测200例患者血清IgG4水平，结合临床表现及其它实验室资料综合分析。结果： 以国际推荐的血清IgG4水平≥1.35g/L为异常时,共有16例患者(含2例门诊患者)血清IgG4异常,男性7例，年龄为52±13岁，女性7例，年龄为63±15岁，其中结核性胸膜炎1例、腹膜后纤维化1例、类风湿性关节炎5例、银屑病性关节炎1例、间质性肾炎，肾衰1例、系统性红斑狼疮，肺纤维化1例、无肌病性皮肌炎1例、风湿性肌痛1例、小红细胞低色素性贫血1例，应用糖皮质激素及免疫抑制剂等治疗均取得良好效疗。结论： IgG4检测对IgG4相关性疾病（如腹膜后纤维化、肺纤维化等）的诊断具有重要的价值外，对其它疾病如类风湿性关节炎等诊断也有一定的意义，IgG4在不同疾病中价值仍需进一步研究。 [关键词]自身免疫性疾病；IgG4相关性疾病；血清 The evaluation of measurement of Immunoglobulin G4 in various diseases Jiang yuzhang，Liu beibei,Liu yan,Wu jian,. Huai’an First People’s Hospital, Nanjing Medical University,Huai’an, Jiangsu 223300, China Corresponding author: Jiang yuzhang, E-mail:JYZ8848@163.com [Abstract] objective： To evaluation the level of serum IgG subtype 4 (IgG4) from various diseases in the diagnosis and treatment. Methods： The levels of serum IgG4 from 150 patients were measured by the immune scattering turbidimetry, meanwhile considered with clinical manifestations. Results： There was 15 patients (including 2 cases of outpatient), including 7 cases of male, 52 ±13 years old, 6 cases of female , 63±15 years old，whose IgG4 levels were abnormally elevated, the serum IgG4 to international recommended limit is according to reference 1.35 g/L, including of 1 case of tuberculous pleurisy , 1 case of retroperitoneal fibrosis, 5 cases of rheumatoid arthritis, 1 case of psoriatic arthritis,1 case of interstitial nephritis and renal failure,1 case of systemic lupus erythematosus with pulmonary fibrosis, 1 case of amyopathic dermatomyositis, 1 cases of rheumatic myalgia, 1case of Microcytosis, the conditions of these patients rapid reversal of even advanced disease with corticosteroid therapy. Conclusion：There is important value for autoimmune diseases such as rheumatoid arthritis diagnosis ,except IgG4 related disease (e.g., retroperitoneal fibrosis, pulmonary fibrosis, etc.) by testing concentration of IgG4.The role of IgG4 detect