Abstract：
OBJECTIVE: The acute-phase protein C-reactive protein (CRP) is known to be associated with poor outcomes in cancer and cardiovascular disease, but there is limited evidence of its prognostic implications in interstitial lung diseases (ILDs). We therefore set out to test whether baseline serum CRP levels are associated with mortality in four different ILDs.
METHODS: In this retrospective study, clinically measured CRP levels, as well as baseline demographics and lung function measures, were collected for ILD patients first presenting to the Royal Brompton Hospital between January 2010 and December 2019. Cox regression analysis was used to determine the relationship with 5-year mortality.
RESULTS: Patients included in the study were: idiopathic pulmonary fibrosis (IPF) n = 422, fibrotic hypersensitivity pneumonitis (fHP) n = 233, rheumatoid arthritis associated ILD (RA-ILD) n = 111 and Systemic Sclerosis associated ILD (SSc-ILD) n = 86. Patients with a recent history of infection were excluded. Higher CRP levels were associated with shorter 5-year survival in all four disease groups on both univariable analyses, and after adjusting for age, gender, smoking history, immunosuppressive therapy and baseline disease severity (IPF: HR (95% CI): 1.3 (1.1-1.5), p = 0.003, fHP: 1.5 (1.2-1.9), p = 0.001, RA-ILD: 1.4 (1.1-1.84), p = 0.01 and SSc-ILD: 2.7 (1.6-4.5), p < 0.001).
CONCLUSIONS: Higher CRP levels are independently associated with reduced 5-year survival in IPF, fHP, RA-ILD and SSc-ILD.
METHODS: In this retrospective study, clinically measured CRP levels, as well as baseline demographics and lung function measures, were collected for ILD patients first presenting to the Royal Brompton Hospital between January 2010 and December 2019. Cox regression analysis was used to determine the relationship with 5-year mortality.
RESULTS: Patients included in the study were: idiopathic pulmonary fibrosis (IPF) n = 422, fibrotic hypersensitivity pneumonitis (fHP) n = 233, rheumatoid arthritis associated ILD (RA-ILD) n = 111 and Systemic Sclerosis associated ILD (SSc-ILD) n = 86. Patients with a recent history of infection were excluded. Higher CRP levels were associated with shorter 5-year survival in all four disease groups on both univariable analyses, and after adjusting for age, gender, smoking history, immunosuppressive therapy and baseline disease severity (IPF: HR (95% CI): 1.3 (1.1-1.5), p = 0.003, fHP: 1.5 (1.2-1.9), p = 0.001, RA-ILD: 1.4 (1.1-1.84), p = 0.01 and SSc-ILD: 2.7 (1.6-4.5), p < 0.001).
CONCLUSIONS: Higher CRP levels are independently associated with reduced 5-year survival in IPF, fHP, RA-ILD and SSc-ILD.
摘要：
目的：已知急性时相蛋白C反应蛋白（CRP）与癌症和心血管疾病的不良预后有关，但其对间质性肺病(ILD)预后影响的证据有限.因此，我们着手测试基线血清CRP水平是否与四种不同ILD的死亡率相关。
方法：在这项回顾性研究中，临床测量的CRP水平，以及基线人口统计学和肺功能测量，收集了2010年1月至2019年12月首次到皇家布朗普顿医院就诊的ILD患者。Cox回归分析用于确定与5年死亡率的关系。
结果：纳入研究的患者为：特发性肺纤维化（IPF）n=422，纤维化过敏性肺炎（fHP）n=233，类风湿性关节炎相关性ILD（RA-ILD）n=111和系统性硬化相关性ILD（SSc-ILD）n=86。有近期感染史的患者被排除在外。在所有四个疾病组中，较高的CRP水平与较短的5年生存率相关。在调整了年龄之后，性别,吸烟史,免疫抑制治疗和基线疾病严重程度（IPF：HR（95％CI）：1.3（1.1-1.5），p=0.003,fHP:1.5(1.2-1.9),p=0.001，RA-ILD：1.4（1.1-1.84），p=0.01和SSc-ILD：2.7（1.6-4.5），p<0.001)。
结论：较高的CRP水平与IPF患者5年生存率降低独立相关，fHP,RA-ILD和SSc-ILD。
方法：在这项回顾性研究中，临床测量的CRP水平，以及基线人口统计学和肺功能测量，收集了2010年1月至2019年12月首次到皇家布朗普顿医院就诊的ILD患者。Cox回归分析用于确定与5年死亡率的关系。
结果：纳入研究的患者为：特发性肺纤维化（IPF）n=422，纤维化过敏性肺炎（fHP）n=233，类风湿性关节炎相关性ILD（RA-ILD）n=111和系统性硬化相关性ILD（SSc-ILD）n=86。有近期感染史的患者被排除在外。在所有四个疾病组中，较高的CRP水平与较短的5年生存率相关。在调整了年龄之后，性别,吸烟史,免疫抑制治疗和基线疾病严重程度（IPF：HR（95％CI）：1.3（1.1-1.5），p=0.003,fHP:1.5(1.2-1.9),p=0.001，RA-ILD：1.4（1.1-1.84），p=0.01和SSc-ILD：2.7（1.6-4.5），p<0.001)。
结论：较高的CRP水平与IPF患者5年生存率降低独立相关，fHP,RA-ILD和SSc-ILD。
