涎液化糖链抗原6在急性加重期特发性间质性肺炎患者中的变化及与预后的关系  

Changes of Krebs Von Den Lungen-6 in Patients with Acute Exacerbation of Idiopathic Interstitial Pneumonia and Its Relationship with Prognosis

作　　者：郭忠[1] 周荣伟[1] 边巍[1] GUO Zhong;ZHOU Rongwei;BIAN Wei(Department of Respiratory and Critical Care Medicine,Shanghai Sixth People′s Hospital,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院呼吸与危重症医学科,上海200233

出　　处：《医学综述》2022年第9期1814-1818,共5页Medical Recapitulate

基　　金：上海市卫生健康委员会科研课题(202040374)。

摘　　要：目的探讨涎液化糖链抗原6(KL-6)在急性加重期特发性间质性肺炎(IIP)患者中的变化及与预后的关系。方法选取2018年9月至2021年9月上海市第六人民医院收治的150例急性加重期IIP患者作为观察组,另选取同期就诊的124例临床稳定期IIP患者作为对照组。比较观察组与对照组患者血清KL-6水平。对观察组患者进行3个月随访,随访截止日期为2021年12月31日,根据随访期间患者是否发生死亡分为死亡组和生存组。比较死亡组和生存组患者血清KL-6水平及其他临床资料,采用Logistic回归分析影响急性加重期IIP患者死亡的危险因素,并绘制受试者工作特征曲线(ROC曲线)分析血清KL-6水平对急性加重期IIP患者预后的预测价值。结果150例急性加重期IIP患者均获得随访,有效随访率为100%,其中62例患者发生死亡。观察组患者血清KL-6水平高于对照组[(2.21±0.04)kU/L比(2.68±0.11)kU/L](t=48.602,P<0.001)。死亡组年龄、KL-6、C反应蛋白、白细胞计数水平高于生存组(P<0.01),第一秒用力呼气量(FEV_(1))、最大自主通气量(MVV)水平低于生存组(P<0.01)。Logistic回归分析结果显示,年龄、FEV_(1)、MVV、KL-6水平均是影响急性加重期IIP患者发生死亡的危险因素(OR=2.337,95%CI 1.059~3.616;OR=3.251,95%CI 1.365~5.137;OR=2.754,95%CI 1.269~4.239;OR=3.766,95%CI 2.203~5.329)(均P<0.01)。ROC曲线分析显示,血清KL-6水平预测急性加重期IIP患者预后的灵敏度、特异度、准确度分别为84.76%、67.23%、82.51%。结论血清KL-6水平在急性加重期IIP患者中异常升高,是影响急性加重期IIP患者发生死亡的危险因素,其水平检测可作为临床辅助评估急性加重期IIP患者预后的有效生化指标。Objective To investigate the changes of krebs von den lungen-6(KL-6)in patients with acute exacerbation of idiopathic interstitial pneumonia(IIP)and its relationship with prognosis.Methods A total of 150 patients with acute exacerbation of IIP admitted to Shanghai Sixth People′s Hospital from Sep.2018 to Sep.2021 were included as an observation group,and 124 patients with clinically stable IIP who were treated during the same period were included as a control group.The serum KL-6 levels of the observation group and the control group were compared.3 months follow-up till Dec.31st 2021 was done on the patients in the observation group,according to death occurrence during the follow-up they were divided into a death group and a survival group.The serum KL-6 level and other clinical data of the death group and survival group were compared,using Logistic regression analysis to figure out risk factors for death of acute exacerbation IIP patients,and receiver operating characteristic curve was drawn to analyze predictive value of serum KL-6 level for prognosis in patients with acute exacerbation of IIP.Results All 150 patients with acute exacerbation of IIP were followed up,with an effective follow-up rate of 100%,and 62 patients died.The serum KL-6 levels in the observation group was significantly higher than that in the control group[(2.21±0.04)kU/L vs(2.68±0.11)kU/L](t=48.602,P<0.001).Age,KL-6,C-reactive protein and white blood cell levels in the death group were significantly higher than those in the survival group(P<0.05),while forced expiratory volume in first second(FEV_(1))and maximal voluntary ventilation(MVV)levels in the death group were significantly lower than those in the survival group(P<0.05).Logistic regression analysis showed that age,FEV_(1),MVV and KL-6 levels were risk factors for death in patients with acute exacerbation of IIP(OR=2.337,95%CI 1.059-3.616;OR=3.251,95%CI 1.365-5.137;OR=2.754,95%CI 1.269-4.239;OR=3.766,95%CI 2.203-5.329)(all P<0.01).ROC curve analysis showed that,the sensitivity,s

关 键 词：特发性间质性肺炎 急性加重期 涎液化糖链抗原6 预后 

分 类 号：R563.13[医药卫生—呼吸系统]