| Objective:The clinical significance of autoantibodies in idiopathic pulmonary fibrosis(IPF)is unclear.By studying the clinical features,laboratory examination and chest high-resolution computed tomography(HRCT)between the two groups of IPF patients with autoantibody-positive and lone IPF,the influence of autoantibodypositive on the prognosis of IPF patients was also analyzed,our aim was to determine the clinical significance and prognosis of autoantibody positivity in IPF.Methods:A total of 95 patients diagnosed with IPF in the First Affiliated Hospital of Nanchang University from January 2012 to January 2018 were retrospectively analyzed.Clinical data and follow-up survival were collected,and SPSS21.0statistical analysis software was used for data analysis.The mortality of patients in the two groups was estimated by Kaplan Meier survival curve,and risk factors were estimated by Cox proportionate risk model.Results:(1)A total of 95 cases were included in this study.The overall mean survival time of IPF patients was 38.99±2.91 months.By the time of follow-up,59 patients had died,with a mortality rate of 62.1%.Compared with the lone IPF group,there were no significant differences in age,gender,smoking history and laboratory tests between the two groups(P > 0.05).Lung function tests showed differences in DLCO%pred,FEV1%pred and FVC%pred between the two groups(P < 0.05).The autoantibody-positive group was superior to the negative group,and honeycombing was more common in the positive group(P < 0.05).(2)Kaplan Meier survival curve showed that the survival prognosis of the autoantibody-positive group was better than that of the lone group(P>0.005),There was no significant difference in survival between different treatment methods of autoantibody groups(P > 0.05).There was no statistically significant difference between different treatments for IPF(P > 0.05).(3)After adjusting for single factor,multivariate Cox proportional risk regression analysis showed that autoantibody positivity(HR=0.686,P= 0.006)age(HR= 1.101,P < 0.001),smoking history(HR= 1.059,P =0.021),DLcopred %(HR=0.966,P < 0.001),FEV1pred%(HR= 0.981,P < 0.001)and FVCpred%(HR= 0.992,P< 0.001)were independent risk factors for death in patients with IPF.Among them,positive autoantibodies,DLCOpred %,FEV1pred% and FVCpred% were positively correlated with prognosis,while age and smoking were prognostic risk factors.Conclusions:Presence of ANCA or autoantibodies of the IPAF serologic domain in IPF patients is associated with better survival outcomes. |
