血清KL-6水平在间质性肺疾病诊断中的价值研究

发布时间：2018-08-02 14:28

【摘要】：目的探讨血清KL-6水平在间质性肺疾病(ILD)中的诊断价值。方法收集2013年4月至2014年4月住院并确诊的ILD患者,并选取其他疾病组及健康对照组作为阴性对照。采用化学发光免疫测定方法测定患者及健康者血清KL-6水平,与肺功能行相关分析,并进行治疗前后比较。结果 ILD组纳入149例,其他肺疾病组纳入155例,健康对照组64例。ILD组患者平均KL-6浓度为(1 801.86±2 831.36)U/m L,其他肺疾病组平均浓度为(267.00±124.41)U/m L,健康对照组平均浓度为(201.28±81.18)U/m L。以500 U/m L为截断值,KL-6诊断ILD的敏感性为83.89%,特异性为92.24%,Kappa值为0.767(P0.001)。KL-6的最佳临界点为469.5 U/m L。ILD组患者KL-6浓度显著高于慢性阻塞性肺疾病、肺炎、肺结核、支气管扩张以及健康人群(P0.001)。ILD亚组分析结果显示,肺泡蛋白沉积症组患者KL-6浓度显著高于隐源性机化性肺炎(COP)组、特发性肺纤维化(IPF)组、结缔组织病相关间质性肺疾病(CTD-ILD)组(均P0.001),IPF组、CTD-ILD组KL-6浓度显著高于COP组(P=0.003,P=0.008)。KL-6浓度与肺活量、用力肺活量、第1秒用力呼气容积、肺一氧化碳弥散量四项占预计值的百分比均呈显著负相关(均P0.001)。KL-6水平与临床疗效一致性较好。结论血清KL-6水平用于诊断ILD具有较高的敏感性和特异性,且与病情严重度及临床疗效相关,具有较高的临床应用价值。
[Abstract]:Objective to investigate the diagnostic value of serum KL-6 level in (ILD) of interstitial lung disease. Methods patients with ILD were collected from April 2013 to April 2014, and other disease groups and healthy controls were selected as negative controls. The level of serum KL-6 was measured by chemiluminescence immunoassay in patients and healthy subjects, and the correlation between serum KL-6 and pulmonary function was analyzed and compared before and after treatment. Results the average concentration of KL-6 was (1 801.86 卤2 831.36) U / mL in ILD group, (267.00 卤124.41) U / m L in other lung disease groups and (201.28 卤81.18) U / m L in healthy control group (n = 64). The mean KL-6 concentration in ILD group was (1 801.86 卤2 831.36) U / m L, and that in other lung diseases group was (267.00 卤124.41) U / m L, and that in healthy control group was (201.28 卤81.18) U / m L, respectively. The sensitivity of KL-6 to diagnose ILD was 83.89, and the best critical point of specificity was 92.2424% Kappa 0.767 (P0.001) .KL-6 was significantly higher in 469.5 Ur / m L.ILD group than in chronic obstructive pulmonary disease, pneumonia, pulmonary tuberculosis. The results of bronchiectasis and healthy subjects (P0.001). ILD subgroup analysis showed that the concentration of KL-6 in patients with alveolar proteinosis was significantly higher than that in patients with cryptogenic pneumonia (COP) and idiopathic pulmonary fibrosis (IPF). The concentration of KL-6 in CTD-ILD group was significantly higher than that in COP group (P0. 003 + P0. 008). KL-6 concentration and vital capacity, forced expiratory volume in 1 second were significantly higher than those in COP group (P0. 003, P0. 008). There was significant negative correlation (P0.001). KL-6 level was consistent with clinical efficacy. Conclusion Serum KL-6 level has high sensitivity and specificity in the diagnosis of ILD, and is related to the severity of the disease and clinical efficacy.
【作者单位】：南京医科大学鼓楼临床医学院呼吸科;南京大学医学院附属鼓楼医院呼吸科;
【基金】：国家自然科学基金(编号:81400046)
【分类号】：R563.9

【参考文献】