Maeda M, Kachi H, Takagi H, Kitajima Y
Department of Dermatology, Gifu University, School of Medicine, Japan.
J Dermatol Sci. 1997 Nov;16(1):38-44. doi: 10.1016/s0923-1811(97)00619-1.
Forty-three patients with systemic scleroderma (SSc), 10 with non-SSc (6 cases of systemic lupus erythematosus and 4 cases of dermatomyositis), 14 cases of mild- or non-sclerotic type of scleroderma with capillaroscopic abnormalities of nailfolds (SSD; scleroderma spectrum disorders) and 10 healthy volunteers (HC) were subjected to examination of plasma levels of endothelin-1 (ET-1). The sex ratios (male/female) in the patients with SSc, non-SSc and HC were 7:36, 4:6 and 0:10, and the ranges of their ages were 22-74, 19-78 and 33-62 years old, respectively. The plasma levels of ET-1 in SSD, SSc (Barnett I;15), SSc (Barnett II;16), SSc (Barnett III;12 cases), non-SSc and HC were 1.67 +/- 0.37 2.04 +/- 0.58 2.04 +/- 0.68 1.85 +/- 041 191 +/- 0.7 and 1.31 +/- 0.34 pg/ml, respectively, confirming previous results from other laboratories. The plasma levels of ET-1 statistically differ between each collagen disease (SSD, SSc and non-SSc) and HC using Student's t-test (P < 0.05). Although a statistically significant difference was obtained in the plasma levels of ET-1 between the SSc group (6 cases) and HC (6 cases) measured at 06:00, 12:00, 18:00 and 24:00 h, there was no significant circadian variation of plasma levels of ET-1 at these times in both the SSc group and HC. The present study revealed that (1) the ET-1 level in HC showed no circadian fluctuation, and remained at a low level (0.8-1.6 pg/ml). (2) When compared to HC, ET-1 in blood plasma of patients with SSc was elevated (0.3-3 pg/ml) throughout the day and night (P < 0.05). (3) ET-1 tended to increase more at midnight (24:00 h) in the SSc group without PSL treatment, though no statistical significance was obtained. (4) TAT showed a significant increase at noon (12:00 h) suggesting coagulation activity in patients with SSc, but PlC did not show a significant increase compared to HC. In conclusion, the observed increase of vasoconstrictive ET-1 in the patients with SSc throughout the day and night may make maintenance of peripheral blood flow more difficult, may have some biological origin and should be further investigated.
对43例系统性硬化症（SSc）患者、10例非SSc患者（6例系统性红斑狼疮和4例皮肌炎）、14例有甲襞毛细血管镜异常的轻度或非硬化型硬皮病（SSD；硬皮病谱系障碍）患者以及10名健康志愿者（HC）进行了血浆内皮素-1（ET-1）水平检测。SSc患者、非SSc患者和HC的性别比（男/女）分别为7:36、4:6和0:10，年龄范围分别为22 - 74岁、19 - 78岁和33 - 62岁。SSD组、SSc组（巴尼特I型；15例）、SSc组（巴尼特II型；16例）、SSc组（巴尼特III型；12例）、非SSc组和HC组的血浆ET-1水平分别为1.67±0.37、2.04±0.58、2.04±0.68、1.85±0.41、1.91±0.7和1.31±0.34 pg/ml，证实了其他实验室先前的结果。使用学生t检验，各胶原病（SSD、SSc和非SSc）与HC组之间的血浆ET-1水平存在统计学差异（P<0.05）。虽然在06:00、12:00、18:00和24:00测量时，SSc组（6例）和HC组（6例）之间的血浆ET-1水平存在统计学显著差异，但在这些时间点，SSc组和HC组的血浆ET-1水平均无显著的昼夜变化。本研究表明：（1）HC组的ET-1水平无昼夜波动，且维持在较低水平（0.8 - 1.6 pg/ml）。（2）与HC组相比，SSc患者血浆中的ET-1在全天均升高（0.3 - 3 pg/ml）（P<0.05）。（3）未接受泼尼松龙（PSL）治疗的SSc组患者在午夜（24:00 h）ET-1有升高趋势，但无统计学意义。（4）SSc患者的凝血酶 - 抗凝血酶复合物（TAT）在中午（12:00 h）显著升高，提示有凝血活性，但纤溶酶 - 纤溶酶抑制物复合物（PlC）与HC组相比无显著升高。总之，观察到SSc患者全天血浆中血管收缩性ET-1升高可能使外周血流维持更加困难，可能有某些生物学原因，值得进一步研究。
