涎液化糖链抗原6对类风湿关节炎相关间质性肺疾病的诊断价值

Serum Krebs von den Lungen-6 level as a diagnostic biomarker for interstitial lung disease associated with rheumatoid arthritis

目的探讨涎液化糖链抗原6(KL-6)在类风湿关节炎相关间质性肺疾病(RA-ILD)中的诊断价值。方法选取2015——2020年在新疆维吾尔自治区人民医院风湿免疫科就诊并明确诊断的RA-ILD患者95例。另选择RA未合并ILD患者89例作为对照。收集患者临床和实验室资料。结果RA-ILD组的平均年龄显著高于RA组[(60±11)岁与(52±12)岁,P<0.01];RA-ILD组抗环瓜氨酸肽(CCP)抗体浓度显著高于RA组[1128.8(443.5,2021.7)U/mL与556.8(118.4,1582.7)U/mL,P<0.01];RA-ILD组血清KL-6水平明显高于RA组[447(281,687)U/mL与195(152,266)U/mL,P<0.01];根据ROC曲线得出判断ILD存在的血清KL-6最佳临界值为277 U/mL,灵敏度为77.9%,特异度为79.8%。结论高龄和高浓度抗CCP抗体为RA患者发生ILD的危险因素;KL-6可作为一种敏感而特异,并且便利、客观的血清学指标诊断RA-ILD。

Objective To evaluate the diagnostic value of salivary liquefied sugar chain antigen(KL-6)in rheumatoid arthritis-related interstitial lung disease(RA-ILD).Methods A total of 95 patients with RA-ILD who were diagnosed in the Department of Rheumatology and Immunology,People′s Hospital of Xinjiang Uygur Autonomous Region from 2015 to 2020 were selected.Eighty-nine RA patients without ILD were selected as controls.The clinical and laboratory data of patients were collected.Results The mean age of RA-ILD group was significantly higher than that of RA group[(60±11)years old vs(52±12)years old,P<0.01].The anti-cyclic citrullinated peptide(CCP)antibody concent in RA-ILD group was significantly higher than that in RA group[1128.8(443.5,2021.7)U/mL vs 556.8(118.4,1582.7)U/mL,P<0.01].Serum KL-6 level in RA-ILD group was significantly higher than that in RA group[447(281,687)U/mL vs 195(152,266)U/mL,P<0.01].According to ROC curve,the optimal critical value of serum KL-6 for RA-ILD was 277 U/mL,with sensitivity of 77.9%and specificity of 79.8%.Conclusion Old age and high concentration of anti-CCP are the risk factors of ILD in RA patients,and KL-6 can be used as a sensitive,specific,convenient and objective serological index to diagnose RA-ILD.