Relationship between Serum SP-A,SP-D,KL-6,miR-21 and Acute Exac-erbation of Idiopathic Pulmonary Fibrosis and Pulmonary Function in Eld-erly Patients
LI Hong
SUN Hui
WANG Long
Abstract：Objective To investigate the relationship of serum surfactant protein-A(SP-A),serum surfactant pro-tein-D(SP-D),high mobility group box-1 protein(HMGB1),Krebs von den Lungen-6(KL-6),and microribonuclease-21(miR-21)with acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)and pulmonary function in elderly patients,in order to improve the early diagnosis rate of AE-IPF and prevent misdiagnosis.Methods A total of 80 elderly patients with AE-IPF admitted from January 2023 to January 2024 were selected as AE-IPF group,another 80 elderly patients with stable idiopathic pulmonary fibrosis(IPE)admitted during the same period were selected as IPF group and 50 healthy elderly pa-tients undergoing physical examination were selected as control group.SP-A,SP-D,HMGB1,KL-6,miR-21 and pulmonary function indexes[forced expiratory volume in the first second(FEV1),FEV1/forced vital capacity(FVC),forced expiratory volume in the first second to the predicted value(FEV1%pred),maximum voluntary ventilation(MVV),maximal voluntary ventilation as a percentage of estimated value(MVV%pred),diffusing capacity of the lungs for carbon monoxide as a percent-age of estimated value(DLCO%pred)]were compared among the three groups.The diagnostic value of serum SP-A,SP-D,HMGB1,KL-6 and miR-21 in AE-IPF was analyzed,and the correlation between serum SP-A,SP-D,HMGB1,KL-6 and miR-21 and pulmonary function indexes was analyzed.Results SP-A,SP-D,HMGB1,KL-6 and miR-21 in IPF group and AE-IPF group were higher than those in control group,and higher in AE-IPF group than in IPF group(P＜0.05).The area under the curve of serum SP-A,SP-D,HMGB1,KL-6,and miR-21 for the diagnosis of AE-IPF was 0.866,0.882,0.890,0.793,and 0.783,respectively,and the sensitivity was 0.800,0.825,0.800,0.763,and 0.813,respectively.FEV1,FEV1/FVC,FEV1%pred,MVV,MVV%pred and DLCO%pred in AE-IPF group and IPF group were lower than those in control group,and lower in AE-IPF group than in IPF group(P＜0.05).Serum SP-A,SP-D,HMGB1,KL-6 and miR-21 were negatively correlated with FEV1,FEV1/FVC,FEV1%pred,MVV,MVV%pred and DLCO%pred(P＜0.01).Con-clusion The detection of the expressions of serum SP-A,SP-D,HMGB1,KL-6 and miR-21 can improve the early diagnosis rate of AE-IPF and prevent misdiagnosis and mistreatment.
Keywords：Idiopathic pulmonary fibrosisAcute exacerbationSurfactant protein-DHigh mobility group box-1 pro-teinForced expiratory volume in one secondMaximal voluntary ventilationDiffusing capacity of the lungs for carbon monoxide
Publication Date：2024-12-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 26-30 )