KL-6在结缔组织病合并间质性肺病诊断中的应用价值

Diagnostic value of serum KL-6 in connective tissue disease associated interstitial lung disease

目的:探讨KL-6在结缔组织病合并间质性肺病诊断中的应用价值。方法:本实验收集自2016年1月至2017年12月就诊于新疆维吾尔自治区人民医院风湿免疫科并确诊的CTD-ILD患者50例,单纯CTD患者46例。记录患者年龄、性别、诊断、肺功能。使用ELISA法测定血清中KL-6水平。所有数据处理均采用SPSS20软件包,其中计量资料统计采用t检验及Mann-Whitney检验,计数资料统计采用χ~2检验,临界值用ROC曲线分析,危险因素分析采用Logistic回归检验,P<0. 05为差异具有统计学意义。结果:本实验共纳入96例患者,其中CTD-ILD患者50例,CTD患者46例,CTD-ILD血清KL-6浓度平均值为(1 962. 1±1 329. 4) mg/L,明显高于CTD组(259. 4±435. 1) mg/L,对比组间存在显著差异(P=0. 000),血清KL-6水平与FVC%、FEV1%及TLco SB%呈负相关。ROC分析其诊断ILD最佳临界值为500 mg/L,其敏感度为82. 0%,特异度为89. 1%,曲线下面积为0. 877。结论:血清KL-6是诊断ILD的重要诊断工具,同时可能也是检测CTD-ILD活动的重要血清标志物。

Objective:To evaluate the diagnosis of the serum Krebs von den Lungen-6(KL-6)for the interstitial lung disease(ILD)associated with connective tissue diseases(CTD).Methods:We retrospectively analyzed the medical records of 50 patients with CTD associated ILD,46 CTD patients without ILD.Measurement of serum KL-6 levels and pulmonary function tests performed were reviewed.T test,χ2 test,non-parametric test,SPSS and correlation analysis were used for data analysis.Results:The significantly higher levels of KL-6 were determined in the CTD-ILD group than in either the CTD without pulmonary involvement group(P<0.05).Serum KL-6 correlated negatively with forced vital capacity(FVC%)(%predicted),forced expiratory volume in one second(FEV1)(%predicted)and diffusing capacity of the lung for single breath transfer factor of carbon monoxide method(TLCO)(%predicted).By the ROC curves of serum KL-6 levels in 96 patients.The optimal cutoff value of serum KL-6 for a diagnosis of CTD-ILD was 500 mg/L,and the sensitivity and specificity were 82.0%and 89.1%,respectively.The area under the curve(AUC)was 0.877.Conclusion:The serum KL-6 is a valuable biomarker for CTD-ILD diagnosis and even as a predictive factor could be used to identify the clinical development of ILD.