血清标志物对原发性干燥综合征合并间质性肺炎预后影响的分析

Analysis of serum markers for the prognosis of primary Sjogren's syndrome with interstitial pneu-monitis

目的分析铁蛋白、糖类抗原(CA)125、CA153、LDH、白蛋白与原发性干燥综合征合并间质性肺炎(pSS-IP)的进展和预后的关系。方法回顾性分析从2011—2017年pSS患者527例,依据肺影像学特点及临床特征进行分组,采用Mann-Whitney U秩和检验分析铁蛋白、CA125、CA153、LDH、白蛋白在各组水平差异,采用Logistic回归对pSS-IP进展的危险因素进行分析。结果① 527例pSS患者中诊断有pSS-IP者206例(39.1%);与无间质性肺炎(pSS-N-IP)患者(321例)比较:pSS-IP患者的铁蛋白、CA125、CA153、LDH相对较高[189(116,380)ng/ml与138(75,258)ng/ml,Z=-3.777,P<0.05;19(12,36)U/ml与12(9,19)U/ml,Z=-5.974,P<0.05;22(12,34)U/ml与9(6,14)U/ml,Z=-4.582,P<0.05;206(165,258)U/L与161(139,195)U/L,Z=-8.770,P<0.05],而白蛋白较低[34(31,37)g/L与36(34,39)g/L,Z=5.210,P<0.05]。②将pSS-IP患者结合肺部影像学特点分为pSS-IP进展组(46例)和pSS-IP稳定组(60例),与pSS-IP稳定组相比,pSS-IP进展组铁蛋白较高[254(129,693)ng/ml与161(104,259)ng/ml,Z=-2.437,P<0.05]。③ Logistic回归分析提示铁蛋白与pSS-IP的进展有一定相关性(OR=1.002)。结论铁蛋白、CA125、CA153、LDH、白蛋白与pSS-IP具有相关性;铁蛋白与pSS-IP的进展具有相关性,是pSS-IP的进展的危险因素。

Objective To analyze the relationship between ferritin, carbohydrate antigen (CA)125, CA153, lactic dehydrogenase (LDH), albumin and progression and prognosis of Sjogren's syndrome with inter-stitial pneumonitis (pSS-IP). Methods Five hundred and twenty-seven primary pSS patients from 2011 to 2017 were analyzed retro-spectively. According to the lung imaging and clinical features, they were divided into groups. The differences of ferritin, CA125, CA153, LDH and albumin (ALB) levels in each group were analyzed by Mann-Whitney U test. Logistic regression was used to analyze the risk factors of pSS complicated with interstitial pneumonitis. Results ① Among the 527 pSS patients, 206 (39.1%) were diagnosed with IP. Compared with 321 patients without interstitial pneumonitis (pSS-N-IP), ferritin, CA125, CA153 and LDH in pSS-IP were relatively higher [189(116, 380) ng/ml vs 138(75, 258) ng/ml, Z=-3.777, P<0.05;19(12, 36) U/ml vs 12(9, 19) U/ml, Z=-5.974, P<0.05;22(12, 34) U/ml vs 9(6, 14) U/ml, Z=-4.582, P<0.05;206(165, 258) U/L vs 161(139, 195) U/L, Z=-8.770, P<0.05], while albumin was lower [34(31, 37) g/L vs 36(34, 39) g/L, Z=5.210, P<0.05].② pSS-IP were divided into pSS-IP progression group (46 cases) and pSS-IP stable group (60 cases) according to their lung imaging characteristics. Compared with pSS-IP stabilization group, pSS-IP progression group had higher ferritin [254(129, 693) ng/ml vs 161(104, 259) ng/ml, Z=-2.437, P<0.05].③ Logistic regres-sion analysis showed that there was correlation between ferritin and the progress of pSS-IP (OR=1.002). Conclusion Ferritin, CA125, CA153, LDH, albumin are related to pSS-IP. Ferritin isrelated to the progress of pSS-IP, and is a risk factor for the progress of pSS-IP.