血清生物标志物对纤维化性间质性肺疾病预后的预测价值  

Predictive value of serum biomarkers in the prognosis of fibrosing interstitial lung diseases

作　　者：赵铁梅[1] 段智梅[1] 刘扬[1] 刘凯迪 华琳[2] 圣朝军 ZHAO Tie-mei;DUAN Zhi-mei;LIU Yang;LIU Kai-di;HUA Lin;SHENG Chao-jun(Department of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China;Department of Biomedicine Informatics, Capital Medical University, Beijing 100069, China)

机构地区：[1]中国人民解放军总医院呼吸与危重症医学部,北京100853 [2]首都医科大学生物医学信息学系,北京100069

出　　处：《河北医科大学学报》2022年第1期26-30,共5页Journal of Hebei Medical University

基　　金：军委后勤保障部卫生局课题(18BJZ21)。

摘　　要：目的探讨与肺泡上皮细胞功能障碍相关的血清生物标志物对纤维化性间质性肺疾病(fibrosing interstitial lung diseases,FILD)预后的预测价值。方法前瞻性入组FILD患者,收集临床资料,检测生物标志物并随访1年进行病情评估。采用竞争风险模型的生存分析和Fine-Gray回归模型提取发展为进行性纤维化型和死亡风险的影响因素。结果共入组58例患者,35例诊断为特发性肺纤维化,14例诊断为结缔组织病相关间质性肺病,9例归为其他原因所致肺纤维化。12例(20.69%)患者发展为进行性纤维化型,8例(13.79%)死亡。单因素分析结果显示发展为进行性纤维化型的风险因素是糖蛋白抗原125(carbohydrate antigen-125,CA-125)基线增高,死亡的风险因素是糖蛋白抗原19-9(carbohydrate antigen 19-9,CA19-9)基线增高;多因素分析结果显示:CA19-9基线增高是死亡的风险因素(回归系数0.007,风险比1.007,95%CI:1.001~1.061,P=0.044)。结论CA-125基线增高的患者发展为进行性纤维化型的风险更高;CA19-9基线增高的患者死亡风险更高。Objective To explore the predictive value of serum biomarkers associated with alveolar epithelial cell dysfunction in the prognosis of fibrosing interstitial lung diseases(FILD).Methods The patients were prospectively enrolled and clinical data were collected.Biomarkers were detected and they were followed up for 1 year to evaluate the condition.Survival analysis of competitive risk model and Fine-Gray regression model were used to extract the risk factors of progressive fibrotic phenotype and death.Results Of the 58 patients,35 cases were diagnosed as idiopathic pulmonary fibrosis,14 as interstitial lung disease associated with connective tissue diseases,9 as pulmonary fibrosis caused by other causes.Of them,12(20.69%)developed into progressive fibrotic phenotype,and 8(13.79%)died.Univariate analysis showed that the risk factor for the development of progressive fibrotic phenotype was the baseline elevation of carbohydrate antigen 125(CA-125),and the risk factor for death was the baseline elevation of carbohydrate antigen 19-9(CA19-9).Multivariate analysis showed that the baseline elevation of CA19-9 was the risk factor for death(regression coefficient 0.007,hazard ratio 1.007,95%confidence interval:1.001-1.061,P=0.044).Conclusion Patients with elevated CA-125 baseline have a higher risk of developing progressive fibrotic phenotype,while patients with elevated CA19-9 baseline have a higher risk of death.

关 键 词：肺疾病 间质性 预后 生物标志物 

分 类 号：R563.13[医药卫生—呼吸系统]