RF、抗CCP抗体、SP-A以及SP-D对类风湿关节炎合并间质性肺病的预测价值

Predictive Value of RF,Anti-CCP Antibodies,SP-A,and SP-D in Rheumatoid Arthritis Combined with Interstitial Lung Disease

目的探讨RF、抗CCP抗体、SP-A以及SP-D对类风湿关节炎(rheumatoid arthritis,RA)合并间质性肺病(interstitial lung disease,IL-D)的预测价值。方法选取2020年12月—2021年12月在顺德和平外科医院治疗的180例RA-ILD患者作为RA-ILD组,同期选取了102例单纯RA患者作为RA组。比较两组类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体、表面活性蛋白(SP)-A及SP-D,并绘制受试者工作特性曲线(ROC)获取曲线下面积(AUC),评估各指标对RA-ILD的预测价值。随访患者6个月时间,根据病情转归情况将RA-ILD组分为两个亚组,即好转组(132例)和进展组(48例),比较两个亚组患者的RF、抗CCP抗体、SP-A、SP-D水平。采用Pearson检验分析RF、抗CCP抗体、SP-A、SP-D与肺间质病变评分的相关性。结果RA-ILD组患者RF、抗CCP抗体、SP-A、SP-D水平均显著高于RA组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,RF(AUC=0.741)、抗CCP抗体(AUC=0.663)、SP-A(AUC=0.825)、SP-D(AUC=0.804)均对RA-ILD具有显著的预测价值(P<0.05)。好转组患者的RF、抗CCP抗体、SP-A、SP-D水平均显著低于进展组,差异有统计学意义(P<0.05)。Pearson相关性检验分析结果显示,RF、抗CCP抗体、SP-A、SP-D与肺间质病变评分均呈现正相关性(r=0.378、0.516、0.526、0.388,P<0.05)。结论RF、抗CCP抗体、SP-A以及SP-D对RA-ILD具有显著的诊断和预后评估价值,可作为病情随访监测的血清学指标。

Objective To investigate the predictive value of RF,anti-CCP antibody,SP-A,and SP-D for rheumatoid arthritis(RA)combined with interstitial lung disease(IL-D).Methods One hundred and eighty patients with RA-ILD treated at Shunde Heping Surgical Hospital from December 2020 to December 2021 were selected as the RA-ILD group,and one hundred and two patients with RA alone were selected as the RA group during the same period.The rheumatoid factor(RF),anti-cyclic citrullinated peptide(CCP)antibody,surface active protein(SP)-A and SP-D were compared between the two groups,and the area under the curve(AUC)was obtained by plotting the subject operating characteristic curve(ROC)to assess the predictive value of each index for RA-ILD.Patients were followed up for 6 months,and the RA-ILD group was divided into two subgroups according to disease regression,namely the improvement group(132 patients)and the progression group(48 patients).The levels of RF,anti-CCP antibodies,SP-A,and SP-D were compared between the two subgroups of patients.The Pearson test was used to analyze the correlation between RF,anti-CCP antibody,SP-A,SP-D and interstitial lung lesion scores.Results The levels of RF,anti-CCP antibody,SP-A,and SP-D were significantly higher in the RA-ILD group than in the RA group,and the difference was statistically significant(P<0.05).ROC curve analysis showed that RF(AUC=0.741),anti-CCP antibody(AUC=0.663),SP-A(AUC=0.825),and SP-D(AUC=0.804)all had a significant predictive value for RA-ILD(P<0.05).The levels of RF,anti-CCP antibodies,SP-A,and SP-D in patients in the improvement group were significantly lower than those in the progression group,and the differences were statistically significant(P<0.05).Pearson correlation test analysis showed that RF,anti-CCP antibodies,SP-A,SP-D and lung interstitial lesion scores all showed positive correlation(r=0.378,0.516,0.526,0.388,P<0.05).Conclusion RF,anti-CCP antibodies,SP-A and SP-D have significant diagnostic and prognostic evaluation value for RA-ILD,and can be used as serological indicators for disease follow-up monitoring.