摘要
目的分析涎液化糖链抗原(KL-6)、癌抗19-9(CA19-9)、癌抗原15-3(CA15-3)和辅助性T细胞17(Th17)鉴别结缔组织病相关的间质性肺病(CTD-ILD)与细菌感染性肺炎的价值。方法选择2017年3月~2020年1月间收治的84例CTDILD患者作为观察组,50例细菌感染性肺炎患者作为对照组;检测受试者血中KL-6、CA19-9、CA15-3和Th17水平;采用Logistics回归模型分析KL-6、CA19-9、CA15-3和Th17与CTD-ILD的相关性及联合预测模型,绘制ROC曲线分各指标单独和联合预测模型鉴别CTD-ILD与细菌感染性肺炎价值。结果观察组患者血中KL-6、CA19-9、CA15-3和Th17水平明显高于对照组,且差异存统计学意义(P <0.05);血清中KL-6、CA19-9、CA15-3和Th17的高表达均是影响CTD-ILD疾病的独立性威胁因素(P <0.05),且预测模型为log(P)=0.439KL-6+0.519CA19-9+0.495CA15-3+0.543Th17;采用KL-6、CA19-9、CA15-3和Th17联合鉴别CTD-ILD和细菌感染性肺炎的敏感度、特异度和AUC均明显高于各指标单独应用,且差异有统计学意义(P <0.05)。结论CTD-ILD患者血中KL-6、TH17和糖蛋白抗原呈明显高表达状态,KL-6、TH17和糖蛋白抗原联合应用鉴别诊断CTD-ILD与细胞感染性肺炎的敏感度和特异度较高,且具有较高的应用价值。
Objective To analyze the value of krebs von den lungen-6(KL-6), cancer antigen 19-9(CA19-9), cancer antigen15-3(CA15-3), and T helper cells 17(Th17) in the identification of connective tissue disease-associated interstitial lung disease(CTD-ILD) and bacterial pneumonia. Methods A total of 84 patients with CTD-ILD admitted to the hospital from March 2017 to January 2020 were included as the observation group, 50 patients with bacterial pneumonia were included as the control group. The levels of serum KL-6, CA19-9, CA15-3, and Th17 of the subjects were determined. The Logistics regression model was used to analyze the association of KL-6, CA19-9, CA15-3, and Th17 with CTD-ILD and establish the joint prediction model of these indicators. The value of each indicator and the joint prediction model in the identification of CTD-ILD and bacterial pneumonia were analyzed by drawing a receiver operating characteristic(ROC) curve. Results The levels of serum KL-6, CA19-9, CA15-3, and Th17 in the observation group were markedly higher than those in the control group, showing a statistically significant difference(P < 0.05).Highly expressed levels of serum KL-6, CA19-9, CA15-3, and Th17 constituted an independent threat factor influencing the CTD-ILD(P < 0.05). The prediction model was as follows: log(P) = 0.439 KL-6+0.519 CA19-9+0.495 CA15-3+0.543 Th17. When KL-6, CA19-9,CA15-3, and Th17 were jointly used to identify the CTD-ILD and bacterial pneumonia, the sensitivity, specificity, and area under the curve(AUC) were all higher than those when using an indicator alone, and the differences were statistically significant(P < 0.05).Conclusion The serum KL-16, Th17, and protein antigens are highly expressed in patients with CTD-ILD. The combined use of KL-6, CA19-9, CA15-3, and protein antigens in the identification of CTD-ILD and bacterial pneumonia has the advantages of high sensitivity and specificity, thus being valuable in the application.
作者
陈曦
唐洁
胡冬
庄利东
安娜
任艳
吴碧涛
谢兴凤
Chen Xi;Tang Jie;Hu Dong;Zhuang Lidong;An Na;Ren Yan;Wu Bitao;Xie Xingfeng(Department of Laboratory,Mianyang Central Hospital,Mianyang,Sichuan,621000,China)
出处
《西南国防医药》
CAS
2020年第12期1080-1083,共4页
Medical Journal of National Defending Forces in Southwest China
基金
四川省卫生和计划生育委员会(17PJ380)。
