| Objective: To investigate the clinical value of serum KL-6 and SP-D expression levels in the diagnosis and disease evaluation of idiopathic pulmonary fibrosis(IPF).Methods: Twenty patients with IPF who were diagnosed and hospitalized in the Department of Respiratory Medicine of the First Hospital of Lanzhou University from March 2018 to June 2019 were collected as the IPF group,and the general data and clinical data such as chest high-resolution CT,pulmonary function,and echocardiography were collected.At the same time,20 healthy normal subjects matched for sex and age who participated in the physical examination in the physical examination center of our hospital at the same time were selected as the control group,and the general data of the patients were collected to detect the expression levels of KL-6 and SP-D in the serum of the two groups by enzyme-linked immunosorbent assay.SPSS 25.0 statistical software was used for statistical analysis to compare whether there were differences in serum KL-6 and SP-D expression levels between the two groups.The correlation of HRCT score,pulmonary function indicators and pulmonary arterial pressure of serum KL-6 and SP-D levels in IPF group was analyzed.ROC curve was drawn according to the results of serum KL-6 and SP-D expression.The optimal cut-off value,sensitivity and specificity of KL-6 and SP-D in the diagnosis of idiopathic pulmonary fibrosis were determined according to the curve.Results:1.Comparison of data in IPF and control group20 patients with idiopathic pulmonary fibrosis were included in the IPF group,including 9 males and 11 females,with the minimum age of 41 years,the maximum age of 86 years and the average age of(68.65±11.58)years;A total of 20 healthy normal subjects were included in the control group,including 11 males and 9 females,with the minimum age of 47 years,the maximum age of 79 years and the average age of(64.45±7.53)years.There was no significant difference in gender and age between the two groups(P > 0.05).2.Comparison of serum KL-6 and SP-D levels in IPF and control group(1)The serum KL-6 level was(541.37±144.10)U/ml in the IPF group and(283.02 ± 138.44)U/ml in the control group,and there was significant difference between the two groups(P<0.05);(2)The serum SP-D level was(109.44±34.77)ng/ml in the IPF group and(53.36 ± 26.78)ng/ml in the control group,and there was significant difference between the two groups(P<0.05);3.Correlation analysis between indicators in the IPF group3.1 Correlation analysis between serum KL-6,SP-D levels and HRCT scores in the IPF groupIn the IPF group,serum KL-6 was positively correlated with SP-D levels(r =0.625,P<0.05);serum KL-6 levels were positively correlated with HRCT scores(r =0.696,P<0.05);and serum SP-D levels were positively correlated with HRCT scores(r = 0.688,P<0.05).3.2 Correlation analysis between serum KL-6,SP-D levels and lung function parameters in IPF groupIn the IPF group,serum KL-6 levels were negatively correlated with FVC%pred and DLco% pred(r =-0.584,-0.618,P < 0.05),positively correlated with FEV1/FVC(r = 0.491,P < 0.05),and not significantly correlated with FEV1% pred,TLC% pred,and RV/TLC(P > 0.05);serum SP-D levels were negatively correlated with FVC% pred and DLco% pred(r =-0.673,-0.606,P < 0.05),and not significantly correlated with FEV1% pred,TLC% pred,RV/TLC,and FEV1/FVC(P > 0.05).3.3 Correlation analysis between serum KL-6,SP-D levels and pulmonary arterial pressure in IPF groupCorrelation analysis was performed between serum KL-6 and SP-D levels and pulmonary arterial pressure in the IPF group.There was no significant correlation between serum KL-6 levels and pulmonary artery pressure(r = 0.420,P > 0.05);there was a positive correlation between serum SP-D levels and pulmonary artery pressure(r = 0.485,P < 0.05).4.ROC curve of serum KL-6 and SP-D in the diagnosis of IPFROC curves were plotted according to serum KL-6 and SP-D expression levels,and according to ROC curve analysis,the optimal cut-off value of serum KL-6 for the diagnosis of IPF was 420 U/mL,the area under the curve was 0.900,the 95%confidence interval was(0.806 – 0.994),and the sensitivity and specificity were 80%and 85%,respectively;the optimal cut-off value of serum SP-D for the diagnosis of IPF was 72 ng/mL,the area under the curve was 0.900,the 95% confidence interval was(0.805 – 0.995),and the sensitivity and specificity were 90% and 80%,respectively.Conclusion:1.Serum KL-6,SP-D levels are correlated with HRCT,pulmonary function,pulmonary arterial pressure and other clinical indicators in patients with IPF;2.Serum KL-6 and SP-D can be used for the diagnosis and disease assessment of IPF;... |
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