KL-6评估特发性肺纤维化病变程度的临床价值  

Clinical value of KL-6 in evaluating the degree of idiopathic pulmonary fibrosis

作　　者：王静[1] 苗姝[1] 佟金平[1] 王涛[2] WANG Jing;MIAO Shu;TONG Jingping;WANG Tao(Xinhua Hospital Affiliated to Dalian University,Dalian 116021,Liaoning,China;Department of Respiratory and Critical Care Medicine,Zhongshan Hospital Affiliated to Dalian University,Dalian 116001,Liaoning,China)

机构地区：[1]大连大学附属新华医院呼吸与危重症医学科,辽宁大连116021 [2]大连大学附属中山医院呼吸与危重症医学一科,辽宁大连116001

出　　处：《西部医学》2023年第1期130-134,共5页Medical Journal of West China

基　　金：大连市医学科学研究计划项目(1711107)。

摘　　要：目的观察涎液化糖链抗原(KL-6)在特发性肺纤维化(IPF)患者血清、肺泡灌洗液(BALF)中的表达变化及分析KL-6与IPF病情严重程度之间的关系。方法选取2017年3月~2021年3月就诊的80例IPF患者作为本项目研究的观察组,收集80例体检中心的健康者作为本项目研究的健康对照组。酶联免疫吸附法(ELISA)检测两组血清中KL-6蛋白的表达水平。两组均行肺功能、高分辨肺CT(HRCT)检查,分析血清KL-6表达水平与肺功能指标-用力肺活量(FVC)、1秒用力呼气容积占预计值百分比(FEV1%pred)及一氧化碳弥散量占预计值的百分比(DLco%pred)及与HRCT检查结果的相关性。ELISA检测KL-6在稳定期和IPF急性加重患者血清中的表达变化。ROC曲线评估KL-6对于预测特发性肺纤维化发生的临床效果。结果KL-6在观察组患者血清的表达水平高于健康对照组(P<0.05)。肺功能指标FVC、FEV1%pred、DLCO%pred低于健康对照组(P<0.05)。HRCT评分高于健康组(P<0.05)。HRCT评分>4分患者血清、BALF的KL-6水平明显高于HRCT≤4分的患者(P<0.05)。观察组患者KL-6蛋白表达水平与肺功能指标FVC、FEV1%pred、DLCO%pred呈负相关(P<0.05),与HRCT评分呈正相关(P<0.05)。ROC曲线分析结果显示血清KL-6、肺功能DLco%pred对于预测IPF发生的AUC值分别为:0.8037、0.9616,两者均可靠。结论KL-6表达水平的高低与IPF患者的肺功能参数、HRCT评分、病情严重程度之间有明确的相关性,可作为IPF病情评估、预后判定的生物学指标。Objective To observe the expression of salivary liquefied sugar chain antigen(KL-6)in serum of patients with idiopathic pulmonary fibrosis(IPF),and analyze the relationship between KL-6 and the severity of IPF.Methods 80 patients with IPF from March 2017 to March 2021 were selected as the observation group,and 80 healthy people in the physical examination center were collected as the healthy control group.The expression levels of KL-6 protein in serum and BALF were detected by enzyme-linked immunosorbent assay(ELISA).Lung function and high-resolution lung CT(HRCT)were performed in both groups.The expression level of KL-6 and lung function indexes-forced vital capacity(FVC)and forced expiratory volume in one second/predict value were analyzed,FEV1%pred and the percentage of carbon monoxide dispersion in the predicted value(DLCO%pred)and their correlation with HRCT results.The expression of KL-6 in serum of patients with stable stage and acute exacerbation of IPF was detected by ELISA.ROC curve evaluated the clinical effect of KL-6 in predicting the occurrence of idiopathic pulmonary fibrosis.Results The serum expression levels of KL-6 in the observation group were higher than those in the healthy control group(P<0.05).The indexes of lung function FVC,FEV1%pred and DLCO%pred in the healthy control group were lower than those in the healthy control group(P<0.05).HRCT score was higher than that in healthy group(P<0.05).The KL-6 levels of serum and BALF in patients with HRCT score>4 were significantly higher than those in patients with HRCT score≤4(P<0.05).The expression level of KL-6 protein in the observation group was negatively correlated with FVC,FEV1%pred and DLCO%pred(P<0.05),and positively correlated with HRCT score(P<0.05).ROC curve analysis showed that the AUC values of serum KL-6 and lung function DLCO%PRED for predicting IPF were 0.8037 and 0.9616,respectively.Conclusion The expression levels of KL-6 has a clear correlation with pulmonary function parameters,HRCT score and severity of IPF,which can be us

关 键 词：特发性肺纤维化 涎液化糖链抗原6 肺功能 胸部高分辨CT 急性加重 

分 类 号：R563[医药卫生—呼吸系统]