【摘要】 目的 探讨血清总胆红素（TBIL）、乳酸脱氢酶（LDH）、肌酸激酶同工酶（CK-MB）检测对特发性间质性肺炎（IIP）患者病情严重程度的诊断价值。方法 回顾性选取2021年1月至2024年12月新乡医学院第一附属医院收治的100例IIP患者作为研究对象，根据患者病情严重程度分为轻度组23例和中重度组77例，比较两组患者的临床资料。采用二元Logistic回归分析IIP患者病情严重程度的影响因素；采用Pearson分析血清TBIL、LDH、CK-MB水平与病情严重程度的相关性；采用受试者工作特征（ROC）曲线评估血清TBIL、LDH、CK-MB水平对IIP患者病情严重程度的诊断价值。结果 轻度组患者的第1秒用力呼气量（FEV₁）、TBIL分别为（2.42±0.40） L、（10.79±2.50）μmol/L，明显高于中重度组的（1.81±0.39） L、（7.57±1.66）μmol/L，血清LDH、CK-MB水平分别为（227.86±27.72） U/L、（26.76±6.48） U/L，明显低于中重度组的（265.52±32.82） U/L、（37.60±8.59） U/L，差异均有统计学意义（P<0.05）;Pearson相关性分析结果显示，血清LDH、CK-MB水平与IIP患者病情严重程度均呈正相关（r=0.525、0.489,P<0.05），血清TBIL水平与病情严重程度呈负相关（r=-0.432,P<0.05）；二元logistic回归分析结果显示，LDH、CK-MB是导致IIP患者病情加重的危险因素（P<0.05）,FEV₁、TBIL是保护因素（P<0.05）;ROC曲线分析表明，血清TBIL、LDH、CK-MB联合检测的曲线下面积（AUC）为0.972，高于上述血清指标单独检测的0.849、0.824、0.835（P<0.01），联合检测的敏感性为89.61%，特异度为95.65%。结论 IIP患者病情处于中重度的占比较高，血清TBIL、LDH、CK-MB水平可反映IIP患者病情严重程度，三者联合检测具有较高的诊断价值。更多还原

【Abstract】 Objective To investigate the diagnostic value of serum total bilirubin（TBIL）, lactate dehydrogenase（LDH）, and creatine kinase isoenzyme（CK-MB） detection for the severity of idiopathic interstitial pneumonia（IIP）.Methods A total of 100 patients with IIP admitted to the First Affiliated Hospital of Xinxiang Medical University from January 2021 to December 2024 were retrospectively selected as the research subjects. According to disease severity,they were divided into a mild group of 23 cases and a moderate to severe group of 77 cases, and the clinical data of the two groups were compared. Using binary logistic regression analysis to investigate the influencing factors of the severity of IIP patients’ condition. Pearson was used to analyze the correlation between serum TBIL, LDH, CK-MB levels and disease severity. The receiver operating characteristic（ROC） curve was utilized to evaluate the diagnostic value of serum TBIL, LDH, and CK-MB levels for the severity of IIP patients. Results The forced expiratory volume in one second（FEV₁） and TBIL levels in the mild group were（2.42±0.40） L and（10.79±2.50） μmol/L, respectively, which were higher than（1.81±0.39） L and（7.57±1.66） μmol/L in the moderate to severe group; the levels of serum LDH and CK-MB in the mild group were（227.86±27.72） U/L and（26.76±6.48） U/L, significantly lower than（265.52±32.82） U/L and（37.60±8.59） U/L in the moderate to severe group; all the differences were statistically significant（P<0.05）. Pearson correlation analysis showed that serum LDH and CK-MB levels were positively correlated with the severity of IIP（r=0.525, 0.489,P<0.05）, while the serum TBIL level was negatively correlated with the disease severity（r=-0.432, P<0.05）. Binary logistic regression analysis revealed that LDH and CK-MB were risk factors for the exacerbation of IIP patients（P<0.05）,whereas FEV₁ and TBIL were protective factors（P<0.05）. ROC curve analysis demonstrated that the area under the curve（AUC） for the combined detection of serum TBIL, LDH, and CK-MB was 0.972, which was higher than the corresponding 0.849, 0.824, and 0.835 for the individual detection of the above serum indicators（P<0.01）. The sensitivity and specificity of the combined detection were 89.61% and 95.65%, respectively. Conclusion A relatively high proportion of IIP patients present with moderate to severe conditions. The levels of serum TBIL, LDH, and CK-MB can reflect the severity of IIP patients, and their combined detection demonstrates high diagnostic value.更多还原