【摘要】：目的探討血清KL-6水平在間質(zhì)性肺疾病(ILD)中的診斷價值。方法收集2013年4月至2014年4月住院并確診的ILD患者,并選取其他疾病組及健康對照組作為陰性對照。采用化學(xué)發(fā)光免疫測定方法測定患者及健康者血清KL-6水平,與肺功能行相關(guān)分析,并進行治療前后比較。結(jié)果 ILD組納入149例,其他肺疾病組納入155例,健康對照組64例。ILD組患者平均KL-6濃度為(1 801.86±2 831.36)U/m L,其他肺疾病組平均濃度為(267.00±124.41)U/m L,健康對照組平均濃度為(201.28±81.18)U/m L。以500 U/m L為截斷值,KL-6診斷ILD的敏感性為83.89%,特異性為92.24%,Kappa值為0.767(P0.001)。KL-6的最佳臨界點為469.5 U/m L。ILD組患者KL-6濃度顯著高于慢性阻塞性肺疾病、肺炎、肺結(jié)核、支氣管擴張以及健康人群(P0.001)。ILD亞組分析結(jié)果顯示,肺泡蛋白沉積癥組患者KL-6濃度顯著高于隱源性機化性肺炎(COP)組、特發(fā)性肺纖維化(IPF)組、結(jié)締組織病相關(guān)間質(zhì)性肺疾病(CTD-ILD)組(均P0.001),IPF組、CTD-ILD組KL-6濃度顯著高于COP組(P=0.003,P=0.008)。KL-6濃度與肺活量、用力肺活量、第1秒用力呼氣容積、肺一氧化碳彌散量四項占預(yù)計值的百分比均呈顯著負相關(guān)(均P0.001)。KL-6水平與臨床療效一致性較好。結(jié)論血清KL-6水平用于診斷ILD具有較高的敏感性和特異性,且與病情嚴重度及臨床療效相關(guān),具有較高的臨床應(yīng)用價值。
[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 鹵2 831.36) U / mL in ILD group, (267.00 鹵124.41) U / m L in other lung disease groups and (201.28 鹵81.18) U / m L in healthy control group (n = 64). The mean KL-6 concentration in ILD group was (1 801.86 鹵2 831.36) U / m L, and that in other lung diseases group was (267.00 鹵124.41) U / m L, and that in healthy control group was (201.28 鹵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.
【作者單位】： 南京醫(yī)科大學(xué)鼓樓臨床醫(yī)學(xué)院呼吸科;南京大學(xué)醫(yī)學(xué)院附屬鼓樓醫(yī)院呼吸科;
【基金】：國家自然科學(xué)基金(編號:81400046)
【分類號】：R563.9

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