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目的探讨细胞角蛋白19片段(CYFRA21-1)在快速进展型间质性肺病(RP-ILD)进展和预后评估中的价值。方法检测RP-ILD患者(RP-ILD组,77例)和非RP-ILD患者(对照组,102例)血清CYFRA21-1水平,分析CYFRA21-1水平与患者血气分析、胸部影像学特征和治疗结局的关系。结果 RP-ILD组患者血清CYFRA21-1水平为9.13(6.53~13.49)ng/ml,高于对照组的3.81(2.39~6.23)ng/ml(P<0.05)。RP-ILD组血清CYFRA21-1水平与患者影像学病灶浑浊度评分(rs=0.604)、毛玻璃影范围评分(rs=0.661)、病灶严重度评分(rs=0.634)以及网状病灶范围评分(rs=0.621)呈正相关(P<0.01),与患者氧分压呈负相关(rs=-0.266,P<0.01)。RP-ILD患者治疗后,好转48例,死亡29例。死亡患者血清CYFRA21-1水平为13.44(10.46~15.51)ng/ml,高于好转患者的6.41(5.73~7.99)ng/ml(P<0.05)。结论 RP-ILD患者血清中CYFRA21-1水平明显升高,可作为血清指标用于对RP-ILD的病情评估及预后判断。
Objective To investigate the value of cytokeratin 19 (CYFRA21-1) in the progression and prognosis of patients with rapidly progressive interstitial lung disease (RP-ILD). Methods Serum levels of CYFRA21-1 were measured in RP-ILD patients (RP-ILD group, 77 patients) and non-RP-ILD patients (control group, 102 patients). The levels of CYFRA21-1 were compared with those of patients with blood gas analysis, chest radiographic features and treatment The outcome of the relationship. Results The level of serum CYFRA21-1 in patients with RP-ILD was 9.13 (6.53 ~ 13.49) ng / ml, which was higher than that of the control group (3.81 ~ 2.39 ~ 6.23) ng / ml (P <0.05). Serum levels of CYFRA21-1 in RP-ILD group were significantly different from those in patients with imaging lesions (rs = 0.604), gross glassography (rs = 0.661), severity of lesions (rs = 0.634) = 0.621) (P <0.01), and negatively correlated with oxygen partial pressure (rs = -0.266, P <0.01). After treatment, RP-ILD patients improved in 48 cases and died in 29 cases. The level of serum CYFRA21-1 in the deceased patients was 13.44 (10.46 ~ 15.51) ng / ml, higher than 6.41 (5.73 ~ 7.99) ng / ml in the improved patients (P <0.05). Conclusion Serum levels of CYFRA21-1 in patients with RP-ILD are significantly elevated, which can be used as a serum index in the evaluation and prognosis of RP-ILD.