特发性肺纤维化患者血清CXCL14水平与预后的关系

Relationship between serum CXCL14 level and prognosis in patients with idiopathic pulmonary fibrosis

目的研究特发性肺纤维化(IPF)患者血清趋化因子配体14(CXCL14)水平与预后的关系。方法选择2013年2月至2017年2月的74例IPF患者作为研究对象。采用酶联免疫吸附法检测IPF患者血清CXCL14水平,并分析其与预后的关系。结果IPF组患者血清CXCL14水平为(323.54±38.02)pg/mL,高于IIP组[(234.75±23.91)pg/mL,P<0.05]和对照组[(178.97±20.51)pg/mL,P<0.05]。IPF患者血清CXCL14水平与FVC%和DLCO%均呈负相关关系,与HRCT评分呈正相关关系。74例IPF患者中,37例(50.00%)患者预后不良,其中18例(24.32%)患者急性加重,7例(9.46%)患者接受肺移植手术治疗,12例(16.22%)患者死亡。血清CXCL14水平诊断IPF患者预后的AUC为0.890(95%CI:0.814~0.967),敏感度和特异度分别为100.00%和75.68%。CXCL14高水平组预后不良发生率高于低水平组,差异有统计学意义(81.82%vs 3.33%,P<0.05)。CXCL14高水平组平均生存时间低于CXCL14低水平组[15.96(95%CI:14.34~17.57)个月vs 23.77(95%CI:23.32~24.22)个月,P<0.05]。Cox单因素及多因素分析结果显示6MWT-SpO 2、FVC%、HRCT评分和CXCL14与IPF患者预后关系密切。结论血清CXCL14能够较好地反应IPF患者病情,检测其水平有助于IPF患者预后评估。

Objective To investigate the relationship between serum chemokine ligand 14(CXCL14)level and prognosis in patients with idiopathic pulmonary fibrosis(IPF).Methods 74 patients with IPF from February 2013 to February 2017 were selected as subjects.The level of serum CXCL14 in patients with IPF was detected by enzyme-linked immunosorbent assay(ELISA),and its relationship with prognosis was analyzed.Results The serum CXCL14 level in the IPF group was(323.54±38.02)pg/mL,which was higher than that in the IIP group[(234.75±23.91)pg/mL,P<0.05]and the control group[(178.97±20.51)pg/mL,P<0.05].Serum CXCL14 levels in IPF patients were negatively correlated with FVC%and DLCO%,and positively correlated with HRCT scores.Of the 74 patients with IPF,37(50.00%)had a poor prognosis,of whom 18(24.32%)had acute exacerbations,7(9.46%)underwent lung transplantation,and 12(16.22%)died.The AUC of diagnosing prognosis of IPF patients with serum CXCL14 level was 0.890(95%CI:0.814~0.967),and the sensitivity and specificity were 100.00%and 75.68%,respectively.The incidence of poor prognosis in the high-level group was higher than that in the low-level group(81.82%vs 3.33%,P<0.05).The average survival time of the CXCL14 high-level group was lower than that of the CXCL14 low-level group[15.96(95%CI:14.34~17.57)months vs 23.77(95%CI:23.32~24.22)months,P<0.05].Cox univariate and multivariate analysis showed that 6MWT-SpO 2,FVC%,HRCT scores and CXCL14 were closely related to the prognosis of patients with IPF.Conclusion Serum CXCL14 can better reflect the condition of IPF patients,and the detection of its level may contribute to the prognosis of IPF patients.