原发性干燥综合征合并间质性肺疾病患者血清中转化生长因子-β1、糖链抗原-6的表达变化及其诊断价值

The expression changes and diagnostic valve of serum transforming growth factor-β1 and krebs von den lungen-6 in patients with primary Sjögren syndrome complicated with interstitial lung disease

目的探讨原发性干燥综合征(primary Sjögren syndrome,PSS)合并间质性肺疾病(interstitial lung disease,ILD)患者血清中转化生长因子-β1(transforming growth factor-β1,TGF-β1)、糖链抗原-6(krebs von den lungen-6,KL-6)的表达变化及其诊断价值。方法选取2018年6月至2020年6月青海省人民医院收治的120例PSS患者为研究对象,根据是否合并ILD,将入选患者分为PSS合并ILD组(63例)和PSS未合并ILD组(57例)。比较两组患者血清TGF-β1和KL-6水平变化,分析TGF-β1与KL-6的相关性,采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析TGF-β1和KL-6对PSS合并ILD的诊断价值,采用多因素Cox回归模型分析影响PSS合并ILD的危险因素。结果PSS合并ILD组患者血清TGF-β1和KL-6水平均显著高于PSS未合并ILD组(均P<0.05)。血清TGF-β1与KL-6水平呈线性正相关(P<0.05)。ROC曲线显示,TGF-β1诊断PSS合并ILD的曲线下面积为0.904,截断值为42.83μg/L,灵敏度和特异度分别为88.23%和41.67%;KL-6诊断PSS合并ILD的曲线下面积为0.907,截断值为410.39 U/ml,灵敏度和特异度分别为89.36%和37.50%。单因素分析显示,TGF-β1和KL-6差异具有统计学意义(均P<0.05);将单因素分析具有统计学差异的因素纳入多因素Cox回归模型,结果显示:TGF-β1和KL-6均为影响PSS合并ILD的危险因素(均P<0.05)。结论PSS合并ILD患者血清TGF-β1和KL-6水平呈高表达,且与PSS合并ILD的发病密切相关,可作为诊断PSS合并ILD的有效指标。

Objective To investigate the expression and significance of serum transforming growth factor-β1(TGF-β1)and krebs von den lungen-6(KL-6)in patients with primary Sjögren syndrome(PSS)complicated with interstitial lung disease(ILD).Method A total of 120 patients with PSS in Qinghai Provincial People's Hospital from June 2018 to June 2020 were selected and divided into PSS with ILD group(63 cases)and PSS without ILD group(57 cases)according to whether complicated with ILD.The changes of serum TGF-β1 and KL-6 levels were compared between the two groups of patients,and the correlation between TGF-β1 and KL-6 were analyzed.The receiver operating characteristic curve(ROC curve)was used to analyze the diagnostic value of TGF-β1 and KL-6 for PSS complicated with ILD,and the multivariate Cox regression model was used to analyze the risk factors affecting PSS complicated with ILD.Result The serum TGF-β1 and KL-6 levels of patients in PSS with ILD group were significantly higher than those in PSS without ILD group(all P<0.05).Serum TGF-β1 and KL-6 levels were linearly positively correlated(P<0.05).The ROC curve showed that the area under the curve for the diagnosis of PSS combined with ILD by TGF-β1 was 0.904,the cut-off value was 42.83μg/L,the sensitivity and specificity were 88.23%and 41.67%,respectively;the area under the curve for the diagnosis of PSS complicated with ILD by KL-6 was 0.907,the cut-off value is 410.39 U/ml,the sensitivity and specificity were 89.36%and 37.50%,respectively.Univariate analysis showed that the differences in TGF-β1 and KL-6 were statistically significant(all P<0.05).The factors with statistical differences in univariate analysis were included in multivariate Cox regression model analysis,and the results showed that TGF-β1 and KL-6 were all risk factors for PSS complicated with ILD(all P<0.05).Conclusion Serum TGF-β1 and KL-6 levels are highly expressed in patients with PSS complicated with ILD,which are closely related to the pathogenesis of PSS complicated with ILD,and can be used as effective indicators for diagnosing PSS complicated with ILD.