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中华肺部疾病杂志(电子版) ›› 2025, Vol. 18 ›› Issue (01) : 140 -144. doi: 10.3877/cma.j.issn.1674-6902.2025.01.024

临床研究

血清LMR、DCN 在肺间质纤维化患者抗纤维化治疗中的变化及临床意义
岳雅丽1,, 史学军2, 田瑶3   
  1. 1. 032200 汾阳,山西医科大学汾阳学院、山西省汾阳医院呼吸与危重症医学科1
    2. 032200 汾阳,山西省汾阳医院CT 室
    3. 032200 汾阳,山西省汾阳医院内分泌科
  • 收稿日期:2024-06-17 出版日期:2025-02-25
  • 通信作者: 岳雅丽

Changes and clinical significance of serum LMR and DCN in anti fibrotic treatment of patients with pulmonary interstitial fibrosis

Yali Yue, Xuejun Shi, Yao Tian   

  • Received:2024-06-17 Published:2025-02-25
  • Corresponding author: Yali Yue
引用本文:

岳雅丽, 史学军, 田瑶. 血清LMR、DCN 在肺间质纤维化患者抗纤维化治疗中的变化及临床意义[J/OL]. 中华肺部疾病杂志(电子版), 2025, 18(01): 140-144.

Yali Yue, Xuejun Shi, Yao Tian. Changes and clinical significance of serum LMR and DCN in anti fibrotic treatment of patients with pulmonary interstitial fibrosis[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(01): 140-144.

目的

分析血清淋巴细胞与单核细胞比值(lymphocyte to monocyte ratio,LMR)、核心蛋白聚糖(decorin,DCN)在肺间质纤维化患者抗纤维化治疗变化及临床意义。

方法

收集2021 年1 月至2023 年1 月我院收治的33 例特发性肺间质纤维化患者为对象,患者口服吡非尼酮片治疗,根据患者治疗1 年间病情进展情况分为,病情稳定21 例为对照组和疾病进展12 例为观察组。 收集患者住院时期间及治疗3 个月后的DCN、LMR 水平,分析特发性肺间质纤维患者病情进展的危险因素,判断血清DCN、LMR 对特发性肺间质纤维患者病情进展的预测。

结果

观察组中降钙素原(procalcitonin,PCT)(0.27±0.08)ng/ml、治疗3 个月DCN 差值(0.57±0.25)、治疗3 个月LMR 差值(0.98±0.32) 高于对照组2 例(9.52%)、(0.21±0.07) ng/ml、(0.38±0.19)、(0.41±0.12)(P<0.05)。 PCT(OR =3.445,95%CI:1.577~7.526)、治疗3 个月DCN 差值(OR =4.486,95%CI:2.053~9.801)、治疗3 个月LMR 差值(OR =3.943,95%CI:1.805~9.615)是特发性肺间质纤维患者病情进展的危险因素(P<0.05)。 血清DCN、LMR 对特发性肺间质纤维患者病情进展的灵敏度分别为0.72、0.86、0.88,特异度分别为0.78、0.77、0.92,曲线下面积分别为0.725(95%CI:0.631~0.827)、0.761(95%CI:0.689~0.875)、0.883(95%CI:0.804~0.951)。

结论

特发性肺间质纤维化患者治疗前后LMR、DCN 变化与病情进展有关,监测治疗前后LMR、DCN 变化可用于判断特发性肺间质纤维化的病情进展。

图1 特发性肺间质纤维化CT 影像表现 A:CT 扫描下双肺近胸膜可见少量磨玻璃样影表现;B:CT 扫描下双肺近外带多发磨玻璃样影表现)
表1 两组IPF 患者的临床资料比较[(±s),n(%)]
临床资料 对照组( =21) 观察组( =12) χ
性别 0.004 0.947
12(57.14) 7(58.33)
9(42.86) 5(41.67)
吸烟 11(52.38) 6(50.00) 0.017 0.895
饮酒 8(38.10) 4(33.33) 0.075 0.784
高血压 7(33.33) 5(41.67) 0.229 0.632
糖尿病 5(23.81) 3(25.00) 0.006 0.939
冠心病 2(9.52) 1(8.33) 0.013 0.909
慢性肺病 2(9.52) 5(41.67) 4.721 0.030
PaO(mmHg) 64.12±12.35 57.28±12.91 1.506 0.142
PaCO(mmHg) 37.85±4.29 39.12±5.07 0.766 0.450
FVC(L) 2.68±0.71 2.52±0.74 0.613 0.544
FEV(L) 1.71±0.36 1.60±0.41 0.803 0.428
CRP(mg/ L) 16.32±2.05 17.51±2.73 1.421 0.165
WBC(×10 / L) 6.42±2.13 7.15±1.72 1.012 0.320
NEUT(%) 62.04±15.19 67.31±14.06 0.984 0.333
PCT(ng/ ml) 0.21±0.07 0.27±0.08 2.250 0.032
ALB(g/ L) 38.01±4.57 36.83±4.81 0.701 0.489
基线DCN(mg/ L) 8.86±1.74 8.25±1.32 1.051 0.301
治疗3 个月DCN差值 0.38±0.19 0.57±0.25 2.461 0.021
基线LMR 4.62±1.85 4.23±1.76 0.593 0.558
治疗3 个月LMR差值 0.41±0.12 0.98±0.32 7.374 0.001
表2 特发性肺间质纤维患者病情进展的危险因素分析
表3 血清DCN、LMR 变化值对IPF 患者病情进展结果
图2 血清DCN、LMR 对特发性肺间质纤维患者病情进展的预测价值分析
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