铁蛋白/淋巴细胞比值在评估DM/PM-ILD严重程度中的诊断准确性研究  

A study on the diagnostic accuracy of the ferritin/lymphocyte ratio for assessing the severity of DM/PM-ILD

作　　者：李建斌 彭一琳 陈丽明[1] 吴锐[1] LI Jianbin;PENG Yilin;CHEN Liming;WU Rui(Department of Rheumatology and Immunology,The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China)

机构地区：[1]南昌大学第一附属医院风湿免疫科,江西南昌330006

出　　处：《临床肺科杂志》2024年第3期325-330,共6页Journal of Clinical Pulmonary Medicine

基　　金：江西省卫生健康委中医处普通科技计划(No.2017A241)。

摘　　要：目的探讨铁蛋白/淋巴细胞比值对皮肌炎/多肌炎合并间质性肺病(DM/PM-ILD)预后不良的预测价值。方法回顾性收集2018年6月-2020年12月南昌大学第一附属医院风湿免疫科就诊具有完整临床资料的皮肌炎/多肌炎合并间质性肺病患者86例。根据HRCT和美国胸科学会和欧洲呼吸学会关于特发性肺纤维化的国际共识声明将患者分为缓解组(n=29)和加重组(n=57)。对两组的人口学特征,临床症状和实验室检查进行比较。通过计算患者ROC曲线,确定FLPR对DM/PM-ILD严重程度的诊断能力。结果加重组患者ESR、CRP、SF、LDH、LLR、SII和FLPR显著高于缓解组患者(P<0.001)。多因素Logisitic回归分析得出,SF、LDH、低淋巴细胞、LLR、SII和FLPR是加重组DM/PM-ILD患者的独立危险因素。ROC曲线分析得出,FLPR曲线下面积为0.947,敏感度为0.649,特异度为1,界值为599。结论铁蛋白/淋巴细胞比值是评估DM/PM-ILD患者严重程度的有效生物标志物,为DM/PM合并ILD患者提供了最佳的临界值,从而使诊断效率最大化。Objective To explore the predictive value of ferritin/lymphocyte ratio(FLPR)in the prognosis of dermatomyositis/polymyositis combined with interstitial lung disease(DM/PM-ILD).Methods A total of 86 patients with complete clinical data of DM/PM-ILD were retrospectively collected from the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University from June 2018 to December 2020.Patients were divided into remission(n=29)and recombination(n=57)according to HRCT and the International consensus statement on idiopathic pulmonary fibrosis from the American Thoracic Society and the European Respiratory Society.Demographic characteristics,clinical symptoms,and laboratory tests were compared between the two groups.The diagnostic ability of FLPR for DM/PM-ILD severity was determined by calculating the ROC curve of patients.Results In the exacerbation group,patients had significantly higher levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),serum ferritin(SF),lactate dehydrogenase(LDH),lymphocyte-to-leukocyte ratio(LLR),systemic immune-inflammation index(SII),and FLPR compared to the remission group(P<0.001).Multivariable logistic regression analysis revealed that SF,LDH,lymphocyte count,LLR,SII,and FLPR were independent risk factors for exacerbation of DM/PM-ILD.ROC curve analysis showed that the area under the FLPR curve was 0.947,the sensitivity was 0.649,the specificity was 1,and the cut-off value was 599.Conclusion The FLPR is an effective biomarker for assessing the severity of DM/PM-ILD,providing an optimal cutoff value for DM/PM patients with ILD to maximize diagnostic efficiency.

关 键 词：铁蛋白/淋巴细胞比值 皮肌炎/多肌炎合并间质性肺病 预后 影响因素分析 

分 类 号：R563[医药卫生—呼吸系统] R593.26[医药卫生—内科学]