中文摘要：

目的检测多发性肌炎，皮肌炎患者血清可溶性人类白细胞抗原-G（sHLA-G）水平，并分析其与多发性肌炎，皮肌炎各临床特征及治疗和预后的关系，探讨血清sHLA-G在多发性肌炎，皮肌炎发病机制中的可能作用。方法利用酶联免疫吸附试验（ELISA）方法测定96例多发性肌炎，皮肌炎患者（其中多发性肌炎26例，皮肌炎70例）和35名健康体检者血清sHLA-G水平，分析血清sHLA-G与多发性肌炎，皮肌炎患者临床特征、实验室指标及治疗、预后的关系。结果血清sHLA-G水平在多发性肌炎，皮肌炎患者[（44±70）U／m1]明显高于健康对照者[（4±5）U／ml，P〈0．01）]。皮肌炎患者组血清sHLA-G水平[（54±81）U／m1]明显高于多发性肌炎患者组[（27±41）U／ml，P=0．004]。血清sHLA．G升高组多发性肌炎／皮肌炎患者中吞咽困难的发生率较sHLA-G正常组明显升高（P=0．001）。sHLA-G水平与CD3＊T细胞和CD4＋T细胞水平均呈负相关（r=-0．233，P=0．047；r=-0．287，P=0．015），与补体C3水平呈正相关（r=-0．284，P=0．021）。初治组患者血清sHLA-G水平[（77±99）U／m1显著高于经治组[（34±52）U／ml，P=-0．021]。但血清sHLA-G水平与疾病活动度无明显相关，糖皮质激素及免疫抑制剂治疗对血清sHLA-G水平也无明显影响。结论血清sHLA-G水平在多发性肌炎，皮肌炎患者中明显升高，并且与外周血CD3＋和C134＋T细胞数呈负相关，临床上与吞咽困难的发生相关，提示sHLA-G可能在多发性肌炎，皮肌炎病理过程中发挥一定作用。

英文摘要：

Objective To investigate the serum levels of soluble human leukocyte antigen （sHLA）-G in patients with polymyositis （PM） or dermatomyositis （DM）, and to analyze its association with clinical features and possible role in the pathogenesis of PM/DM. Methods Serum sHLA-G levels of 26 patients with PM, 70 patients with DM and 35 matched healthy controls were measured by ELISA. The relationship between the sHLA-G levels and clinical features or seroimmunological data in the patients with PM/DM was analyzed. Results Serum levels of sHLA-G in PM/DM patients were significantly higher compared to healthy controls [ （44±70） U/ml vs （4±5） U/ml, P〈0.01 ]. There was statistically significant difference between DM patients and PM patients [（54±81） U/ml vs （27±41） U/ml, P=0.004]. The incidence of dysphagia was significantly higher in sHLA-G elevated group than those in sHLA-G normal group （P=0.001）. Additionally, Spearman rank correlation analysis showed that the serum sHLA-G levels were positively correlated with serum C3 （r=0.284, P--O.021）, but negatively correlated with CD3~ T cells （r=-0.233, P=0.047） and CD4＋ T cells （r=--0.287, P=0.015） in the peripheral blood in patients with PM/DM. Serum levels of sHLA-G in non-treated PM/DM patients were significantly higher compared to treated patients [（77±99） U/ml vs （34±52） U/ml, P=0.021 ]. No relationship between serum sHLA-G levels and PM/DM disease activity, or different drug therapy was found. Conclusion Serum levels of sHLA-G are increased in PM/DM patients. The increased production of sHLA-G, paralleled with higher incidence of dysphagia and lower level of CD2＋ T cells and CD4＋ T cells, indicates that sHLA-G may play an important role in the pathogenesis of PM/DM.