作者：Nagai M 翻译：刘佩玲 校正：于若寒

摘要：目的：感染对影响ANCA相关性血管炎患者病死率很重要，有必要早期、小心控制感染。我们调查应用血清可溶性血红蛋白清道夫受体CD163来检测感染并发症的发生率，不管疾病活动性如何。

方法：我们通过酶联免疫吸附法（ELISA）从45例日本MPO-ANCA相关性血管炎患者血清中获得可溶性CD163。我们分别评估了36例活动性血管炎患者、36例未感染的非活动性血管炎患者以及19例有感染并发症的非活动性血管炎患者。同时我们也测定了15例非血管炎的传染病患者和30例健康对照组的可溶性CD163水平。

结果：平均血清可溶性CD163水平在具有感染并发症的患者中高于活动性血管炎患者、非活动性血管炎患者、健康对照组。血清可溶性CD163水平与白细胞计数（WBC）、C反应蛋白（CRP）水平、血清白蛋白水平有显著的正相关性，但在多元回归分析中只有CRP水平与血清CD163水平相关。受试者工作特征曲线（ROC曲线）中，血清可溶性CD163水平区分感染患者和非感染患者的敏感性为80.6%，特异性为86.7%。在活动性血管炎患者中，合并肺泡出血的患者的平均血清可溶性CD163水平显著低于合并间质性肺病以及无肺部病变的患者。

结论：血清可溶性CD163水平可能作为一种检测MPO—ANCA相关性血管炎患者感染并发症的有用标记物。

附原文：Abstract：The contribution of infections to the mortality of patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is important, and early and careful infection control is necessary. We investigated the usefulness of the serum-soluble haemoglobin scavenger receptor CD163 for detecting the presence of infectious complications regardless of disease activity.Soluble CD163 in serum obtained from 45 Japanese patients with myeloperoxidase (MPO)-AAV was measured by an enzyme-linked immunosorbent assay (ELISA). We evaluated 36 samples from active-vasculitis patients, 36 samples from inactive-vasculitis patients without infection, and 19 samples from inactive-vasculitis patients with infectious complications. Serum-soluble CD163 was also measured in 15 infectious patients without vasculitis and in 30 normal controls.The mean serum-soluble CD163 level was higher in the patients with infectious complications than in the active-vasculitis patients, inactive-vasculitis patients, and normal controls. There were significant positive correlations between serum-soluble CD163 levels and white blood cell (WBC) count, serum C-reactive protein (CRP) levels, and serum albumin levels, but only serum CRP levels were correlated with serum-soluble CD163 levels in a multiple regression analysis. On the receiver-operating characteristic (ROC) curve, serum-soluble CD163 levels had 80.6% sensitivity and 86.7% specificity for differentiating patients with infection from those without infection. Among the active-vasculitis patients, the mean serum-soluble CD163 level of the patients with alveolar haemorrhage was significantly lower than that of the patients with interstitial lung diseases and that of the patients without pulmonary lesions.The serum-soluble CD163 level may be a useful marker for the detection of infectious complications in MPO-AAV patients.

摘自：Nagai M, Hirayama K, Ebihara I, Higuchi T, Shimohata H, Kobayashi M.Serum levels of the soluble haemoglobin scavenger receptor CD163 in MPO-ANCA-associated renal vasculitis.Scand J Rheumatol. 2016 Apr 20:1-7.