■这项研究的目的是探索KrebsvondenLungen-6(KL-6)的潜在价值,中性粒细胞与淋巴细胞比率(NLR),全身免疫炎症(SII),血小板与淋巴细胞比率(PLR),单核细胞与淋巴细胞比率(MLR)和红细胞分布宽度(RDW)在诊断和评估结缔组织疾病相关性间质性肺病(CTD-ILD)的严重程度中。
■于2022年5月至2023年5月在山西省人民医院招募了140例结缔组织病(CTD)患者和85例CTD-ILD患者。根据用药史和CTD亚型将患者分为亚组,比较分析CTD-ILD患者和CTD患者的临床资料和实验室指标。采用受试者工作特征曲线(ROC)评价KL-6、NLR、SII,PLR,MLR,和RDW从CTD患者中识别CTD-ILD患者。进行了Spearman相关性分析,以阐明这些标志物与强迫肺活量的肺功能参数之间的相关性(FVC,%),一秒钟内强制过期卷(FEV1,%),和一氧化碳的扩散能力(DLCO,%).最后,应用二元logistic回归分析鉴别CTD-ILD的独立危险因素.
■NLR,SII,MLR,RDW,和KL-6在实验组中显示出显著的统计学差异。在未治疗和治疗的亚组中,在所有CTD亚型中,KL-6的CTD-ILD值高于CTD。在未经处理的亚组中,类风湿性关节炎(RA)和RA-ILD患者的MLR水平存在显著差异,Sjögren综合征(SjS)和SjS-ILD患者的NLR水平存在显著差异.“其他CTD”和“其他CTD-ILD”组之间的RDW-SD也存在显着差异。在治疗的亚组中,RA和RA-ILD患者的RDW-SD和RDW-CV和NLR之间存在显着差异,SII,MLR,PLR,和“其他CTD”和“其他CTD-ILD”组之间的RDW-SD。ROC显示KL-6在治疗组和未治疗组中作为CTD-ILD的最有效预测因子。多因素logistic回归分析结果显示,KL-6和年龄是CTD-ILD的独立危险因素。NLR,SII,未处理CTD-ILD组PLR与DLCO(%)呈负相关,在治疗和未治疗的CTD-ILD组中,KL-6与各种肺功能参数呈负相关。
■KL-6成为诊断CTD-ILD和评估其严重程度的最有希望的生物标志物。KL-6的诊断值不受药物干扰的影响,超过了其他参数的值,例如NLR,SII,MLR,和RDW。RDW-SD对CTD-ILD患者的诊断价值高于RDW-CV。NLR,SII,MLR,PLR对诊断不同类型的CTD-ILD有潜在价值。
UNASSIGNED: The aim of this study was to explore the potential values of Krebs von den Lungen-6 (KL-6), neutrophil to lymphocyte ratio (NLR), systemic immune inflammation (SII), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR) and red blood cell distribution width (RDW) in the diagnosis and evaluation of the severity of connective tissue disease-associated interstitial lung disease (CTD-ILD).
UNASSIGNED: A total of 140 connective tissue disease (CTD) patients and 85 CTD-ILD patients were recruited for this study at Shanxi Provincial People\'s Hospital from May 2022 to May 2023. Patients were divided into subgroups based on medication history and CTD subtypes to compare and analyze the clinical data and laboratory parameters of CTD-ILD patients and CTD patients. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of KL-6, NLR, SII, PLR, MLR, and RDW in identifying CTD-ILD patients from CTD patients. A Spearman correlation analysis was conducted to elucidate the correlations between these markers and the lung function parameters of forced vital capacity (FVC, %), forced expired volume in one second (FEV1, %), and diffusing capacity of carbon monoxide (DLCO, %). Finally, binary logistic regression analysis was applied to discern the independent risk factors for CTD-ILD.
UNASSIGNED: NLR, SII, MLR, RDW, and KL-6 displayed significant statistical differences in the experimental groups. In both untreated and treated subgroups, KL-6 displayed higher values for CTD-ILD than CTD among all CTD subtypes. In untreated subgroups, there were significant differences in MLR levels between rheumatoid arthritis (RA) and RA-ILD patients and in NLR levels between Sjögren syndrome (SjS) and SjS-ILD patients. There were also significant differences in RDW-SD between the \"other CTD\" and \"other CTD-ILD\" groups. In treated subgroups, there were significant differences in both RDW-SD and RDW-CV between RA and RA-ILD patients and in NLR, SII, MLR, PLR, and RDW-SD between \"other CTD\" and \"other CTD-ILD\" groups. ROC revealed that KL-6 emerged as the most effective predictor for CTD-ILD in both treated and untreated groups. The multivariate logistic regression analysis results showed that both KL-6 and age were independent risk factors for CTD-ILD. NLR, SII, and PLR were negatively correlated with DLCO (%) in the untreated CTD-ILD group, and KL-6 was negatively correlated with various lung function parameters in both treated and untreated CTD-ILD groups.
UNASSIGNED: KL-6 emerged as the most promising biomarker for diagnosing CTD-ILD and assessing its severity. The diagnostic value of KL-6 was unaffected by medication interference and surpassed the value of other parameters, such as NLR, SII, MLR, and RDW. The diagnostic value of RDW-SD was higher than that of RDW-CV in CTD-ILD patients. NLR, SII, MLR, and PLR have potential value in diagnosing the different types of CTD-ILD.