血清涎液化糖链抗原-6联合谷丙转氨酶、C反应蛋白和红细胞沉降率辅助诊断多发性肌炎/皮肌炎合并间质性肺疾病的临床价值OA

Objective To investigate the diagnostic efficacy of serum Krebs von den Lungen-6(KL-6)levels combined with alanine aminotransferase(ALT),C-reactive protein(CRP)and eryth-rocyte sedimentation rate(ESR)in polymyositis/dermatomyositis complicated with interstitial lung disease(PM/DM-ILD).Methods A total of 55 patients with polymyositis(PM)/dermatomyositis(DM)were selected as the study subjects.According to the presence or absence of interstitial lung disease(ILD),the patients were divided into non-interstitial lung group(PM/DM-NILD,n=22)and interstitial lung group(PM/DM-ILD,n=33).Additionally,30 healthy individuals who underwent physical examinations at the same period were selected as healthy control group.The serum KL-6 levels of the study subjects were measured.Clinical data of the patients were collected,including aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase MB isoenzyme(CK-MB),heparin-binding protein(HBP),α-hydroxybutyrate dehydrogen-ase(HBDH),ALT,CRP and ESR.The differences in serum KL-6 levels among the three groups were compared.A logistic regression model was established to analyze the independent risk factors for PM/DM-ILD and to construct a combined model.The efficacy of KL-6,ALT,CRP and ESR in the single and combined diagnosis of PM/DM-ILD was evaluated using the receiver operating charac-teristic(ROC)curve.Results The serum KL-6 level in the PM/DM-ILD group was higher than that in the PM/DM-NILD group and the healthy control group,with statistically significant differ-ences(P＜0.05).Binary multivariate logistic analysis showed that elevated levels of KL-6,ALT,CRP and ESR were independent risk factors for PM/DM-ILD(OR=1.006,1.063,1.027 and 1.081,P＜0.05).The ROC curve results indicated that the area under the curve(AUC)for KL-6 in the auxiliary diagnosis of PM/DM-ILD was 0.944,with a sensitivity of 89.7％and a specificity of 94.4％;the AUC for the combined diagnosis of PM/DM-ILD using KL-6,ALT,CRP and ESR was 0.983,with a sensitivity of 96.6％and a specificity of 94.4％.Conclusion KL-6 is a highly effective biomarker for the diagnosis of PM/DM-ILD,and the combined model constructed with ALT,CRP and ESR can effectively reduce the risk of missed diagnosis of PM/DM-ILD.