AST/ALT ratio as a predictor of mortality and exacerbations of PM/DM-ILD in 1 year-a retrospective cohort study with 522 cases.
AST/ALT ratio as a predictor of mortality and exacerbations of PM/DM-ILD in 1 year-a retrospective cohort study with 522 cases.
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AST/ALT 比值作为 PM/DM-ILD 1 年死亡率和恶化的预测因子——522 例回顾性队列研究
DOI：
10.1186/s13075-020-02286-w
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发表时间：
2020-09-20
影响因子：
4.9
通讯作者：
Luo F
中科院分区：
文献类型：
--
作者：
Li R;Zhu WJ;Wang F;Tang X;Luo F
评估天冬氨酸转氨酶/丙氨酸转氨酶比值（DRR）与多发性肌炎/皮肌炎相关间质性肺病（PM/DM-ILD）患者死亡率之间的关系。这是一项回顾性队列研究，纳入了2008年1月1日至2018年12月31日期间在四川大学华西医院接受入院时DRR检测的522例PM/DM-ILD患者。使用考克斯回归模型估计4个预先确定的DRR分层中死亡率的风险比（≤ 0.91、0.91-1.26、1.26-1.73和> 1.73），在校正年龄、性别、DRR分层、诊断、重叠综合征、血红蛋白、血小板计数、白色血细胞计数、中性粒细胞百分比、中性粒细胞/淋巴细胞比值、白蛋白、肌酸激酶、尿酸/肌酐比值、甘油三酯或低密度脂蛋白。在多变量考克斯回归分析中，较高的DRR（> 1.73）是1年死亡率的独立预测因子（风险比3.423，95% CI 1.481-7.911，p = .004）。在1年随访时，DRR较高的患者更经常需要使用机械通气和因PM/DM-ILD急性加重而再次入院。PM/DM-ILD患者入院时DRR较高与1年随访中死亡率、机械通气风险和住院率增加相关。这种低成本、易于获得、快速测量的生物标志物可能有助于识别可从强化管理中获益的高风险PM/DM-ILD患者。
To assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD). This was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008, to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91–1.26, 1.26–1.73, and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides, or low-density lipoprotein. Higher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481–7.911, p = .004). Patients with higher DRR more often required the use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up. Higher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation, and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.
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