结缔组织病相关间质性肺炎患者血清KL-6与LDH水平变化及其临床意义  

Changes of serum KL-6 and LDH levels in patients with connective tissue disease-associated interstitial pneumonia and their clinical significance

作　　者：郭冬梅[1] 张红卫[1] 罗绮雯[1] GUO Dongmei;ZHANG Hongwei;LUO Qiwen(Department of Rheumatology and Immunology,Foshan First People′s Hospital,Foshan,Guangdong 528000,China)

机构地区：[1]广东省佛山市第一人民医院风湿免疫科,528000

出　　处：《重庆医学》2020年第22期3733-3738,共6页Chongqing medicine

基　　金：佛山市医学类科技攻关项目(2017AB001501);广东省自然科学基金项目(2017A030310596)。

摘　　要：目的分析结缔组织病相关间质性肺炎(CTD-IP)患者血清涎液化糖链抗原-6(KL-6)、乳酸脱氢酶(LDH)水平变化及其临床意义。方法选取2018年1月至2019年12月该院收治的CTD患者96例,其中56例合并IP者纳入观察组,40例不合并IP者纳入对照组,比较两组血清KL-6、LDH、C反应蛋白(CRP)水平、红细胞沉降率(ESR)、肺功能指标[用力呼气量(FVC)、1秒用力呼气容积占预计值百分比(FEV1%)、FEV1/FVC比值]及胸部高分辨CT(HRCT)结果,对比CTD-IP中不同疾病活动度(稳定期、急性加重期)患者各指标水平;分析CTD-IP患者各指标相关性,以及CTD-IP患者治疗6个月后血清KL-6、LDH水平变化。结果入院时观察组血清KL-6、LDH、CRP水平、ESR、HRCT磨玻璃样改变发生率及斑点斑片状影发生率明显高于对照组(P<0.05),FEV1%、FEV1/FVC比值明显低于对照组(P<0.05);急性加重期CTD-IP患者入院时血清KL-6、LDH、CRP水平及HRCT磨玻璃样改变发生率及斑点斑片状影发生率明显高于稳定期患者(P<0.05);相关性分析显示,CTD-IP患者血清KL-6与LDH、CRP、HRCT磨玻璃样改变发生率及斑点斑片状影发生率呈正相关(r=0.486、0.419、0.373、0.365,P<0.05);CTD-IP患者治疗后KL-6、LDH水平均下降,且稳定期患者治疗1、3个月后KL-6变化值低于急性加重期患者,而治疗6个月后KL-6变化值高于急性加重期患者(P<0.05),稳定期患者治疗1、3、6个月后LDH变化值均高于急性加重期患者(P<0.05)。结论CTD-IP患者血清KL-6、LDH水平升高,治疗6个月后明显下降,且其水平与患者疾病活动度有一定关系,可作为CTD-IP患者的疗效监测指标。Objective To analyse changes in serum levels of Kerbs von den Lungen-6(KL-6)and lactate dehydrogenase(LDH)in patients with connective tissue disease-associated interstitial pneumonia(CTD-IP)and their clinical significance.Methods A total of 96 CTD patients admitted to this hospital from January 2018 to December 2019 were enrolled,including 56 cases with IP(the observation group)and 40 cases without IP(the control group).The serum levels of KL-6,LDH and C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),lung function indexes[forced vital capacity(FVC),percentage of forced expiratory volume in one second to predicted value(FEV1%),FEV1/FVC ratio],and the results of chest high-resolution CT(HRCT)were compared between the two groups.The levels of above indexes were compared between CTD-IP patients with different disease activity(stable phase and acute exacerbation phase).The correlations among all indexes as well as changes in serum levels of KL-6 and LDH in CTD-IP patients after 6 months of treatment were analysed.Results The serum levels of KL-6,LDH and CRP,ESR,and incidence rates of frosted glass-like shadow and speckle-like patchy shadows detected by HRCT in the observation group were significantly hgiher than those in the control group at admission(P<0.05),while FEV1%and FEV1/FVC ratio weresignificantly lower than those in the control group(P<0.05).The serum levels of KL-6,LDH and CRP,incidence rates of frosted glass-like shadow and speckle-like patchy shadows detected by HRCT in patients with acute exacerbation of CTD-IP were significantly higher than those in patients in the stable phase(P<0.05).Correlation analysis showed that serum KL-6 was positively correlated with LDH,CRP and incidence rates of frosted glass-like shadow and speckle-like patchy shadows in CTD-IP patients(r=0.486,0.419,0.373,0.365,P<0.05).After treatment,the serum levels of KL-6 and LDH in CTD-IP patients decreased.Additionally,the change values of serum KL-6 level after 1 and 3 months of treatment in patients in the stable phase we

关 键 词：结缔组织病 间质性肺炎 涎液化糖链抗原-6 乳酸脱氢酶 肺功能 相关性分析 

分 类 号：R563.1[医药卫生—呼吸系统]