Predictive Value of Inflammatory Markers in Connective Tissue Disease-associated Interstitial Lung Diseases with Respiratory Failure

LIU Shengfei; LI Long

doi:10.13730/j.issn.2097-2148.2024.02.010

Abstract：Objective To discuss the predictive value of inflammatory markers in connective tissue disease-associat-ed interstitial lung diseases(CTD-ILDs)with respiratory failure(RF).Methods The basic data,oxygen partial pressure(PaO2),partial pressure of carbon dioxide(PaCO2),white blood cell(WBC),lymphocyte(LYM),monocyte(MONO),neutrophil(NEUT),platelet(PLT),hemoglobin(Hb),albumin(ALB),erythrocyte sedimentation rate(ESR),C reactive protein(CRP),procalcitonin(PCT)of 200 patients with CTD-ILDs admitted to author's hospital from January 2017 to May 2023 were retrospectively analyzed;the levels of neutrophil to lymphocyte ratio(NLR),plate-let-to-lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR),systemic immune inflammatory index(SII),prog-nostic nutritional index(PNI)and systematic immune inflammation nutritional index(SIINI)of the two groups were calculated.According to the results of PaO2 at ad-mission,the patients were divided into RF group and non-RF group.The basic data of the two groups were com-pared,and the Spearman correlation analysis was per-formed between the inflammatory indicators and PaO2 levels;the risk factors of RF in CTD-ILDs patients were analyzed by multivariate Logistic regression analysis;the predictive value of inflammatory markers for CTD-ILDs complicated with RF patients was analyzed by receiver operating characteristic(ROC)curve.Results The course of disease,age,WBC,MONO,NEUT,CRP,PCT,NLR,SII and SIINI levels in the RF group were obviously higher than those in non-RF group(all P＜0.05),while the PaO2,LYM,LMR and PNI were obviously lower than those in non-RF group(all P＜0.05).The PaO2was negatively correlated with NLR,SII,SIINI,but positively correlated with LMR and PNI;NLR was positively correlated with SII,SIINI,but negatively correlated with LMR and PNI;SII was positively correlated with SI-INI,but negatively correlated with LMR;SIINI was negatively correlated with LMR and PNI;LMR was positively corre-lated with PNI(all P＜0.05).Elevated NLR was independent risk factor and predictive factor of CTD-ILDs complicated with RF,the area under the curve(AUC)of NLR predicting CTD-ILDs complicated with RF was 0.765,the AUC of SII and SIINI predicting CTD-ILDs complicated with RF were 0.684 and 0.683 respectively,while the combining AUC of the three was 0.783.Conclusion Elevated NLR is an independent risk factor for CTD-ILDs patients complicated with RF.The combination of NLR,SII and SIINI is better than any single indicator in predicting CTD-ILDs patients complicated with RF.