Jiang Xiangpin, Shang Li, Hou Chunfeng
Department of Rheumatology, Jining No. 1 People's Hospital, Jining, People's Republic of China.
Int J Gen Med. 2025 Jul 11;18:3811-3821. doi: 10.2147/IJGM.S523981. eCollection 2025.
To investigate the clinical significance and correlation of plasma D-dimer, fibrinogen (FIB), and serum cytokines in patients with idiopathic inflammatory myopathy (IIM).
Fifty patients with IIM and 50 healthy controls were included. Plasma D-dimer, FIB, and serum cytokine levels in IIM patients were analyzed and contrasted with the control group. The association between coagulation indicators and key clinical indices, as well as cytokines was also analyzed in IIM patients. Subgroup analyses were performed based on the presence of interstitial lung disease (ILD). Correlations among the variables were tested using Spearman correlation analysis.
The levels of D-dimer, FIB, interleukin (IL)-1β, IL-6, IL-8, IL-18, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ were significantly higher in the IIM group compared to healthy controls (all p ≤ 0.001). In IIM patients, plasma D-dimer was positively correlated with serum alanine aminotransferase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), and ferritin, while negatively correlated with manual muscle test (MMT8) score, peripheral blood lymphocyte count, and hemoglobin (p <0.05). Plasma FIB was positively associated with C-reactive protein, ESR, and ferritin (p <0.05). Additionally, plasma D-dimer showed significantly positive correlations with IL-1β (r = 0.325, p = 0.021), IL-6 (r =0.309, p = 0.029), IL-8 (r = 0.347, p = 0.014), and IL-18 (r = 0.333, p = 0.018). In subgroup analyses, serum IFN-γ levels were significantly higher in IIM patients with ILD compared to those without ILD (p = 0.021), while no significant differences were observed in D-dimer or FIB levels between these two groups.
Elevated plasma D-dimer in IIM patients may be associated with disease activity, with cytokines playing a potentially important role. Both D-dimer and cytokines hold clinical significance in evaluating the disease status of IIM patients.
探讨特发性炎性肌病(IIM)患者血浆D-二聚体、纤维蛋白原(FIB)及血清细胞因子的临床意义及相关性。
纳入50例IIM患者和50例健康对照者。分析IIM患者的血浆D-二聚体、FIB及血清细胞因子水平,并与对照组进行对比。还分析了IIM患者凝血指标与关键临床指标以及细胞因子之间的关联。根据间质性肺疾病(ILD)的有无进行亚组分析。采用Spearman相关性分析检验变量之间的相关性。
与健康对照组相比,IIM组的D-二聚体、FIB、白细胞介素(IL)-1β、IL-6、IL-8、IL-18、肿瘤坏死因子(TNF)-α和干扰素(IFN)-γ水平显著更高(均p≤0.001)。在IIM患者中,血浆D-二聚体与血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、红细胞沉降率(ESR)和铁蛋白呈正相关,而与徒手肌力测试(MMT8)评分、外周血淋巴细胞计数和血红蛋白呈负相关(p<0.05)。血浆FIB与C反应蛋白、ESR和铁蛋白呈正相关(p<0.05)。此外,血浆D-二聚体与IL-1β(r = 0.325,p = 0.021)、IL-6(r = 0.309,p = 0.029)、IL-8(r = 0.347,p = 0.014)和IL-18(r = 0.333,p = 0.018)呈显著正相关。在亚组分析中,与无ILD的IIM患者相比,有ILD的IIM患者血清IFN-γ水平显著更高(p = 0.021),而两组之间的D-二聚体或FIB水平无显著差异。
IIM患者血浆D-二聚体升高可能与疾病活动相关,细胞因子可能起重要作用。D-二聚体和细胞因子在评估IIM患者疾病状态方面均具有临床意义。