高密度脂蛋白检测在特发性炎性肌病相关间质性肺病中的临床意义

    Significance of high density lipoprotein detection in idiopathic inflammatory myopathy associated with interstitial lung disease

      摘要
    • 摘要:
      目的  探讨血清高密度脂蛋白在特发性炎性肌病（IIM）合并间质性肺病（ILD）患者中的表达及可能的临床意义。
      方法  抽取2018年8月～2024年5月在空军军医大学唐都医院初治的143例特发性炎性肌病患者，根据是否合并间质性肺病，分为IIM无ILD组（57例）和IIM-ILD组（86例），分析其临床资料，比较两组患者的临床特征、实验室指标，采用多因素Logistic回归，分析总结IIM合并ILD的危险因素，采用受试者工作特征（receiver operator characteristic, ROC）曲线评估高密度脂蛋白对IIM合并ILD的预测价值。
      结果 IIM-ILD组患者在年龄（P<0.01）及技工手（P<0.05）的发生率方面均高于IIM无ILD组患者；IIM-ILD组血清白蛋白（ALB）（34 ± 5） vs. （37 ± 5）， P<0.01、高密度脂蛋白（0.9 ± 0.3） vs. （1.2 ± 0.5），P<0.01 低于IIM无ILD组，血清铁蛋白水平542（305, 961）vs. 330（155, 555）, P<0.01，抗Ro-52抗体阳性率57% vs. 33%，P<0.05高于IIM无ILD组；Logistic回归分析结果显示：年龄大、抗Ro-52抗体阳性、技工手是IIM-ILD的独立危险因素（均P<0.05），HDL是IIM-ILD的独立保护因素（P<0.01）；用HDL判断IIM-ILD的ROC曲线下面积为0.766（95%CI：0.684～0.849），当高密度脂蛋白临界值取1.06时，其判断价值最高，灵敏度60.71%，特异度84.88%。
      结论  血清高密度脂蛋白是IIM-ILD的独立保护因素，血清高密度脂蛋白减低的IIM患者，更易合并间质性肺病。

       

      Abstract:
      AIM  To investigate the expression of serum high-density lipoprotein in patients with idiopathic inflammatory myopathy (IIM) complicated with interstitial lung disease (ILD) and its possible clinical significance.
      METHODS A total of 143 IIM patients, who were initially treated at Tangdu Hospital, Air Force Medical University from August 2018 to May 2024, were divided into IIM without ILD group (57 cases) and IIM-ILD group (86 cases) according to whether they were combined with ILD. Their clinical data were analyzed and clinical characteristics and laboratory indexes of the two groups were compared. Multifactor logistic regression was used to analyze the risk factors of IIM combined with ILD and the predictive value of HDL for IIM-ILD was evaluated by using receiver operator characteristic (ROC) curve.
      RESULTS The incidence of age (P<0.01) and skilled worker (P<0.05) in the IIM-ILD group was higher than that in the IIM group without ILD; The serum albumin (ALB) (34 ± 5) vs. (37 ± 5), P<0.01 and high-density lipoprotein (0.9 ± 0.3) vs. (1.2 ± 0.5), P<0.01 levels in the IIM-ILD group were lower than those in the IIM without ILD group. The serum ferritin levels 542 (305, 961) vs. 330 (155, 555), P<0.01, and the positivity rate of anti-Ro-52 antibodies 57% vs. 33%, P<0.05 were higher than those in the IIM without ILD group; The results of logistic regression analysis showed that age, positive anti-Ro-52 antibodies, and skilled workers were independent risk factors for IIM-ILD (all P<0.05), while HDL was an independent protective factor for IIM-ILD (P<0.01); The area under the ROC curve of IIM-ILD determined by HDL is 0.766 (95% CI: 0.684～0.849). When the critical value of high-density lipoprotein is set at 1.06, its diagnostic value is the highest, with a sensitivity of 60.71% and a specificity of 84.88%.
      CONCLUSION Serum high-density lipoprotein is an independent protective factor for IIM-ILD.

       

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