涎液化糖链蛋白6在特发性肺纤维化患者支气管肺泡灌洗液和血清中的表达及临床意义

Expression and Significance of KL-6 in BALF and Serum of Patients with Idiopathic Pulmonary Fibrosis

目的检测涎液化糖链蛋白6(KL-6)在特发性肺纤维化(IPF)患者支气管肺泡灌洗液(BALF)和血清中的表达水平,探讨其临床意义。方法选取IPF患者34例,Ⅰ期结节病(SAR)患者10例,用酶联免疫吸附法(ELISA)测定KL-6在BALF及血清中的水平。结果 IPF组患者的用力肺活量(FVC)占预计值百分比(FVC%pred)显著低于SAR组[(69.51±13.65)%比(82.06±5.84)%,P<0.01],一氧化碳弥散量(DLCO)占预计值百分比(DLCO%pred)显著低于SAR组[(48.58±12.73)%比(81.47±6.39)%,P<0.01]。IPF组患者BALF中中性粒细胞百分比高于SAR组[(8.91±6.79)%比(5.50±3.60)%,P<0.05],SAR组淋巴细胞百分比和CD4/CD8高于IPF组[(23.30±12.68)%比(11.71±6.64)%,P<0.05;(4.01±5.10)比(1.46±0.83),P<0.05]。IPF组患者BALF和血清中KL-6浓度高于SAR组[(437.43±251.70)U/m L比(221.59±127.41)U/m L,P<0.05;(857.81±515.53)U/m L比(338.67±168.13)U/m L,P<0.001]。血清KL-6水平与FVC和DLCO明显相关(r=-0.46,r=-0.58)。结论 IPF患者BALF和血清中KL-6水平均增高,血清KL-6水平与FVC和DLCO相关,KL-6有可能作为一项提示IPF临床诊断和严重程度的指标。

Objective To detect the levels of Krebs yon den lungen 6 （KL-6） in bronchoalveolar lavage fluid （BALF） and serum of patients with idiopathic pulmonary fibrosis （IPF） ,and explore its clinical significance. Methods Thirty-four patients with IPF and 10 patients with sarcoidosis in I period were recruited in the study. ELISA was used to detect the level of KL-6 in BALF and serum. Results In the IPF group,the forced vital capacity as percentage of predicted value （FVC% pred） and diffusion capacity for carbon monoxide as percentage of predicted value （DLCO% pred） were both significantly lower than those of the sarcoidosis group [ （ 69. 51±13.65 ） % vs. （ 82. 06 ± 5. 84 ） %, （48.58 ± 12. 73 ） % vs. （ 81.47 ± 6. 39）% ,P 〈 O. 01 ]. In the BALF of IPF group, the percentage of neutrophils was higher [ （ 8.91 ± 6. 79） % vs. （5.50 ± 3.60） %, P 〈 0. 05 ], and the percentages of lymphocytes and CD4/CDs ratio were lower than those of the sarcoidosis group [ （ 11.71 ± 6. 64） % vs. （ 23.30 ± 12. 68 ） %, （ 1.46 ± 0. 83 ） vs. （4. O1 ±5.10） ,P 〈0. 05 ]. In the IPF group,the level of KL-6 in the BALF and serum was higher than that of the arcoidosis group [ （437. 43 ± 251.70） U/mL vs. （221.59 ± 127.41 ） U/mL, （857. 81 ± 515.53 ） U/mL vs. 4338.67 ± 168. 13） U/mL,P 〈0. 001 ]. There was obvious correlation between the level of serum KL-6 with FVC%pred and DLCO% pred in the IPF group （r = -0.46,r = -0.58,P 〈0.05）. Conclusions The level of KL-6 in BALF and serum is elevated in patients with IPF. There is obvious correlation between the level of serum KL-6 with FVC% pred and DLCO% pred in IPF patients. KL-6 mhy be an indicator of IPF in clinical diagnose.