目的 分析研究多发性肌炎(polymyositis，PM)患者抗PM-SCL抗体、抗Jo-1抗体、血清涎液化糖链抗原(Krebs von den Lungen-6，KL-6)表达与合并肺间质疾病(interstitial lung disease，ILD)的关系。方法 选取2020年2月到2023年2月开封市中心医院收治的PM患者81例，根据是否合并肺间质疾病分为PM组(n=48)和PM合并ILD组(n=33)。比较两组一般资料、抗PM-SCL抗体、抗Jo-1抗体阳性率和血清KL-6表达情况，采用Spearman和Pearson相关检验分析抗PM-SCL抗体、抗Jo-1抗体、血清KL-6表达与HRCT评分的关系，采用多因素logistic回归分析影响PM合并ILD的危险因素，通过受试者工作特征(ROC)曲线评估血清KL-6对PM合并ILD的预测价值。结果 PM合并ILD组年龄、咳嗽咳痰比例、胸闷憋喘比例、MYOACT评分、HRCT评分均显著高于PM组(P＜0。05);PM合并ILD组抗PM-SCL抗体、抗Jo-1抗体阳性率和血清KL-6表达均显著高于PM组(P＜0。05);相关检验结果显示，PM合并ILD患者抗PM-SCL抗体、抗Jo-1抗体、血清KL-6表达与HRCT评分呈显著正相关(P＜0。05);多因素logistic回归分析显示，年龄、MYOACT评分、抗PM-SCL抗体、抗Jo-1抗体、血清KL-6是影响PM合并ILD的危险因素(P＜0。05);ROC诊断曲线结果显示，以678。92 U/mL为最佳截点值，KL-6预测PM合并ILD的敏感度为87。88％，特异度为91。67％，曲线下面积为0。916(95％CI:0。843～0。989)。结论 抗PM-SCL抗体、抗Jo-1抗体阳性以及血清KL-6表达上升是影响PM合并ILD的危险因素，通过检测血清KL-6表达并结合抗PM-SCL抗体、抗Jo-1抗体状态对PM合并ILD具有一定的预测价值。
Study on relationship between autoantibodies and serum Krebs von den lungen-6 expression and interstitial lung disease in patients with polymyositis
Objective To analyze and study the relationship of anti-PM-SCL antibody,anti-Jo-1 antibody and serum Krebs von den lungen-6(KL-6)expression with interstitial lung disease(ILD)in patients with polymyositis(PM).Methods Totally 81 patients with PM admitted to the hospital from February 2020 to February 2023 were selected and di-vided into PM group(n=48)and PM with ILD group(n=33)according to whether ILD occurred.General data,positive rates of anti-PM-SCL antibody and anti-Jo-1 antibody and serum KL-6 expression were compared between the two groups.Spearman and Pearson correlation tests were used to analyze the relationship between anti-PM-SCL antibody,anti-Jo-1 antibody and serum KL-6 expression and HRCT score.Multivariate logistic regression analysis was applied to analyze the risk factors of PM with ILD.The predictive value of serum KL-6 on PM with ILD was evaluated by receiver operating characteristic(ROC)curve.Results Age,proportion of cough and sputum,proportion of chest tightness and suffocation,MYOACT score and HRCT score in PM with ILD group were significantly older or higher than those in PM group(P＜0.05).The positive rates of anti-PM-SCL antibody and anti-Jo-1 antibody and serum KL-6 expression-were significantly higher in PM with ILD group than those in PM group(P＜0.05).Correlation test results showed that anti-PM-SCL antibody,anti-Jo-1 antibody and serum KL-6 expression in patients with PM and ILD were signifi-cantly positively correlated with HRCT score(P＜0.05).Multivariate logistic regression analysis revealed that age,MYO-ACT score,anti-PM-SCL antibody,anti-Jo-1 antibody and serum KL-6 were the risk factors of PM with ILD(P＜0.05).ROC diagnostic curve results showed that with 678.92 U/mL as the best cut-off value,the sensitivity and specificity of KL-6 in predicting PM with ILD were 87.88％and 91.67％,and the area under the curve was 0.916(95％CI:0.843-0.989).Conclusion Positive anti-PM-SCL antibody,positive anti-Jo-1 antibody and increased serum KL-6 expression are risk factors of PM with ILD.Detection of serum KL-6 expression combined with anti-PM-SCL antibody and anti-Jo-1 antibody has certain predictive value on PM with ILD.
PolymyositisInterstitial lung diseaseAnti-PM-SCL antibodyAnti-Jo-1 antibodyKrebs von den lungen-6
NETL
NSTL
万方数据
