【摘要】 目的探讨血清KL-6检测在特发性炎性肌病(IIM)合并肺间质病变(ILD)诊断中的作用。方法多发性肌炎(PM)和皮肌炎(DM)患者53例,其中合并有ILD的22例,正常对照者50名及肺部感染患者22例。酶联免疫吸附试验(ELISA)检测血清KL-6浓度。分析PM/DM患者临床表现及预后与血清KL-6水平的相关性。结果血清KL-6浓度在合并ILD的PM/DM组、未合并ILD的PM/DM组、肺部感染组和正常对照组的平均值分别是(1543±761)、(429±106)、(336±196)和(289±105)U/ml。合并ILD的PM/DM组血清KL-6水平较未合并ILD的PM/DM组、肺部感染组和正常对照组均显著升高(P＜0．01)。而未合并ILD的PM/DM组、肺部感染组和正常对照组间差异无统计学意义(P＞0．05)。血清KL-6的升高与肺间质病变呈显著正相关(P＜0．01),KL-6诊断PM/DM合并ILD的敏感性为90．9%,特异性为80．6%。随访分析表明,6例死亡的PM/DM患者血清KL-6水平明显高于其他伴发ILD的PM/DM患者(P＜0．01)。结论血清KL-6浓度是PM/DM合并ILD特异和敏感的血清学指标,它可用来鉴别肺部感染和肺间质病变。高水平的血清KL-6浓度可能提示预后差。更多还原

【Abstract】 Objective To determine the serum level of KL-6 in patients with polymyositis(PM)and dermatomyositis(DM),and to investigate the possible diagnostic value for interstitial lung diseases(ILD)in pa- tients with PM/DM.Methods Serum KL-6 concentrations were measured by ELISA in 53 adult PM/DM pa- tients,the control groups of 22 patients with infectious lung disease,and 50 healthy subjects.The association with clinical features and serum KL-6 levels was analyzed.Results The serum levels of KL-6 were(1543±761)、(429±106)、(336±196)and(289±105)U/ml in PM/DM patients with ILD and without ILD,patients with infectious lung disease and healthy controls,respectively.Serum KL-6 levels in the PM/DM patients with ILD were significantly higher compared with PM/DM patients without ILD,patients with infectious lung disease and healthy controls(all P＜0.01 ).However,no significant differences of serum KL-6 levels was found among PM/ DM patients without ILD,patients with infectious lung disease and healthy controls(P＞0.05).Significant cor- relations were found between the elevated levels of serum KL-6 and the presence of ILD in patients with PM/ DM(P＜0.01).The sensitivity and specificity of serum abnormal KL-6 levels for ILD in patients with PM/DM were 90.9% and 80.6%.Additionally,follow-up study showed the mean serum levels of KL-6 in six patients who died were significantly higher than that in other PM/DM patients with ILD(P＜0.01).Conclusion Serum KL-6 level is a reliable serum marker for ILD in idiopathic inflammatory myopathies,which may contribute to early differentiate ILD from lung infectious disease.Increased serum level of KL-6 may predict a poor out- come.更多还原