结缔组织病相关肺间质病变患者血清KL-6水平变化及临床意义

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摘要目的探究结缔组织病相关肺间质病变（CTD-ILD）患者血清涎液化糖链抗原（KL-6）水平变化及临床意义。方法选择2018年5月—2019年10月江苏省连云港第二人民医院（以下简称“我院”）诊治的80例CTD-ILD患者为CTD-ILD组，选择同期在我院治疗的69例CTD未合并ILD患者为CTD-NILD组。根据高分辨率CT结果将CTD-ILD组患者进一步划分为寻常型间质性肺炎（UIP）组20例、非特异性间质性肺炎（NSIP）组46例和未定型组14例，比较各组的血清KL-6水平。Pearson法分析血清KL-6与肺功能指标的相关性，受试者工作特征曲线（ROC）分析血清KL-6水平对CTD-ILD的诊断价值。结果 CTD-ILD组血清KL-6水平高于CTD-NILD组；而最大摄氧量（VO2max）、肺弥散容量（DLco/SB）和每单位肺容积时的肺弥散量（DLco/VA）均低于CTD-NILD组（均P < 0.05）。UIP组血清KL-6水平高于NSIP组和未定型组，NSIP组血清KL-6水平高于未定型组（均P < 0.05）。血清KL-6水平与VO2max、DLco/SB和DLco/VA均呈负相关（r = -0.777、-0.711、-0.553，P < 0.05）。ROC曲线显示血清KL-6截断值为384.68 U/mL时，曲线下面积为0.832（95%CI：0.767~0.897），敏感度、特异性分别为0.81、0.87。结论 CTD-ILD患者血清KL-6水平异常升高，而肺功能明显下降，并且肺功能降低与血清KL-6水平升密切相关。

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关键词 ：结缔组织病相关肺间质病变, 涎液化糖链抗原, 肺功能, 高分辨率CT

Abstract：Objective To investigate the changes of serum krebsvon den lungen-6 (KL-6) level in patients with connective tissue disease associated interstitial lung disease (CTD-ILD) and its clinical significance. Methods From May 2018 to October 2019, 80 cases with CTD-ILD treated in the Second People′s Hospital of Lianyungang of Jiangsu Province (“our hospital” for short) were selected as the CTD-ILD group, and 69 cases with CTD without ILD treated in our hospital during the same period were selected as the CTD-NILD group. Patients in the CTD-ILD group were further divided into usual interstitial pneumonia (UIP) group with 20 cases, nonspecific interstitial pneumonia (NSIP) group with 46 cases and undefined group with 14 cases according to high resolution CT result, and serum KL-6 level of each groups were compared. The correlation between serum KL-6 and lung function index was analyzed by Pearson method, and the diagnostic value of serum KL-6 level in CTD-ILD was analyzed by receiver operating characteristic (ROC) curve. Results The serum KL-6 level of the CTD-ILD group was higher than that of the CTD-NILD group, while maximum oxygen uptake (VO2max), lung diffusion capacity (DLco/SB) and lung dispersion per unit lung volume (DLco/VA) were lower than those of the CTD-NILD group (all P < 0.05). Serum KL-6 level in UIP group was higher than that in NSIP group and undefined group, and serum KL-6 level in NSIP group was higher than that in undefined group (all P < 0.05). Serum KL-6 level was negatively correlated with VO2max, DLco/SB and DLco/VA (r = -0.777, -0.711, -0.553, P < 0.05). ROC curve showed that the when cut-off value of serum KL-6 was 384.68 U/mL, the area under the curve was 0.832 (95%CI: 0.767-0.897), and the sensitivity and specificity were 0.81 and 0.87, respectively. Conclusion Serum KL-6 level in CTD-ILD patients is elevated abnormally, while lung function decreased significantly. The reduced lung function is closely related to the elevation of serum KL-6 level.

Key words： Connective tissue disease associated interstitial lung disease Krebsvon den lungen-6 Lung function High resolution CT

基金资助:江苏省科技计划项目（B2017041）。

通讯作者: 李慧（1986.3-），女，硕士；研究方向；风湿病学。

作者简介: 王田玲（1989.2-），女，硕士；研究方向：风湿病学。

引用本文:

王田玲崔佳佳李慧. 结缔组织病相关肺间质病变患者血清KL-6水平变化及临床意义[J]. 中国医药导报, 2020, 17(28): 91-95.
WANG Tianling CUI Jiajia LI HuiDepartment of Rheumatology Immunology, the Second People′s Hospital of Lianyungang, Jiangsu Province, Lianyungang 222000, China. Changes of serum KL-6 level in patients with connective tissue disease associated interstitial lung disease and its clinical significance. 中国医药导报, 2020, 17(28): 91-95.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I28/91

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