Diot E, Giraudeau B, Diot P, Degenne D, Ritz L, Guilmot J L, Lemarié E
Groupe de Recherche Epithélium Respiratoire et Inflammation, Service de Médecine Interne B, CHU Bretonneau, Tours, France.
Chest. 1999 Sep;116(3):715-20. doi: 10.1378/chest.116.3.715.
To determine the value of the level of anti-topoisomerase I (anti-topo I) to evaluate lung involvement defined by abnormal high-resolution computed tomography (HRCT) score and pulmonary function tests (PFTs) in systemic sclerosis (SS).
Forty-eight patients with SS, 20 with lung involvement and 28 with no lung involvement.
PFT measurement, HRCT scoring of lung involvement, and anti-topo I assay by enzyme-linked immunosorbent assay. Normal anti-topo I level was defined as < 30.
There was a significant association between cutaneous extent and anti-topo I level (6.5% of patients with limited cutaneous scleroderma had abnormal anti-topo I levels vs 70.6% of patients with diffuse cutaneous scleroderma, p = 0.0001). In patients with diffuse cutaneous scleroderma, pulmonary involvement was associated with a higher percentage of abnormal anti-topo I level: 91.7% vs 20% (p = 0.010). In patients with diffuse cutaneous scleroderma, a significant association was found between the class of anti-topoII level and total lung capacity (median, 69 in patients with abnormal anti-topo I level vs 87 in patients with normal anti-topo I level, p = 0.010), between the class of anti-topo I level and HRCT score (median, 12 in patients with abnormal anti-topo I level vs 5 in patients with normal anti-topo I level, p = 0.05).
Anti-topo I can be considered as a marker of lung involvement in patients with diffuse cutaneous scleroderma.
确定抗拓扑异构酶I（抗拓扑异构酶I）水平在评估系统性硬化症（SS）中由异常高分辨率计算机断层扫描（HRCT）评分和肺功能测试（PFT）定义的肺部受累情况时的价值。
48例SS患者，其中20例有肺部受累，28例无肺部受累。
进行PFT测量、对肺部受累情况进行HRCT评分，并通过酶联免疫吸附测定法检测抗拓扑异构酶I。正常抗拓扑异构酶I水平定义为<30。
皮肤受累范围与抗拓扑异构酶I水平之间存在显著关联（局限性皮肤硬皮病患者中有6.5%抗拓扑异构酶I水平异常，而弥漫性皮肤硬皮病患者中有70.6%，p = 0.0001）。在弥漫性皮肤硬皮病患者中，肺部受累与抗拓扑异构酶I水平异常的比例较高相关：91.7% 对20%（p = 0.010）。在弥漫性皮肤硬皮病患者中，发现抗拓扑异构酶II水平类别与肺总量之间存在显著关联（抗拓扑异构酶I水平异常的患者中位数为69，抗拓扑异构酶I水平正常的患者中位数为87，p = 0.010），抗拓扑异构酶I水平类别与HRCT评分之间也存在显著关联（抗拓扑异构酶I水平异常的患者中位数为12，抗拓扑异构酶I水平正常的患者中位数为5，p = 0.05）。
抗拓扑异构酶I可被视为弥漫性皮肤硬皮病患者肺部受累的标志物。
