人Ⅱ型肺泡细胞表面抗原在类风湿关节炎并间质性肺炎与肺部感染中的鉴别诊断价值

Differential diagnostic value of type Ⅱ alveolar cell surface antigen in rheumatoid arthritis with interstitial pneumonia and pulmonary infection

目的探讨人Ⅱ型肺泡细胞表面抗原(KL-6)在类风湿关节炎(RA)并间质性肺炎与肺部感染中的鉴别诊断价值。方法选取常州市第二人民医院2013年7月—2014年12月收治的RA患者50例,根据疾病类型不同分为间质性肺炎组22例与肺部感染组28例,并选取本院同期健康体检者20例为健康对照组,以ELISA方法检测3组受检者血清KL-6水平并比较,分析KL-6对RA并间质性肺炎的鉴别诊断价值。结果间质性肺炎组患者KL-6水平高于肺部感染组、健康对照组,差异有统计学意义(P<0.05);肺部感染组与健康对照组KL-6水平比较,差异无统计学意义(P>0.05)。以KL-6≥500U/ml为标准,KL-6对RA并间质性肺炎的鉴别诊断灵敏度为90.9%,特异度为82.1%。以KL-6≥550U/ml为标准,KL-6对RA并间质性肺炎鉴别诊断的灵敏度为81.8%,特异度为92.8%。结论血清KL-6水平可有效鉴别诊断RA患者并间质性肺炎与肺部感染。

Objective To investigate the differential diagnostic value of type Ⅱ alveolar cell surface antigen( KL-6) in rheumatoid arthritis( RA) with interstitial pneumonia and pulmonary infection. Methods A total of 50 cases of RA patients were selected from July 2013 to December 2014 in Changzhou Second People’s Hospital,which were divided into interstitial pneumonia group( n = 22) and pulmonary infection group( n = 28) according to the different type of disease,20 cases of healthy people were selected during same period in our hospital as healthy control group. KL-6 level was tested and compared among the three groups,and differential diagnostic value of KL-6 and RA were analysed. Results KL-6 level of interstitial pneumonia group was higher than pulmonary infection group and healthy control group( P < 0. 05); no statistically significant differences was found in KL-6 level between pulmonary infection group and healthy control group( P > 0. 05). As for the standard of KL-6≥500U / ml,the differential diagnosis sensitivity of KL-6 to RA with interstitial pneumonia was 90. 9%,the specificity was 82. 1%. As for the standard of KL-6≥550U / ml,the differential diagnosis sensitivity of KL-6 to RA with interstitial pneumonia was 81. 8%,the specificity was 92. 8%. Conclusion Serum KL-6 level can effectively identify the patients with RA wiyh interstitial pneumonia and pulmonary infection.