Lung ultrasound B-lines and serum KL-6 correlate with the severity of idiopathic inflammatory myositis-associated interstitial lung disease
Lung ultrasound B-lines and serum KL-6 correlate with the severity of idiopathic inflammatory myositis-associated interstitial lung disease
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DOI：
10.1093/rheumatology/kez571
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发表时间：
2020-08-01
期刊：
影响因子：
5.5
通讯作者：
Furst, Daniel E.
中科院分区：
文献类型：
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作者：
Wang, Yukai;Chen, Shaoqi;Furst, Daniel E.
目的：特发性炎症性肌炎相关间质性肺疾病（IIM-ILD）显着增加发病率和死亡率。肺部超声 B 线和 Krebs von den Lungen-6 (KL-6) 分别被确定为 ILD 的新超声和血清标志物。我们工作的目的是评估 B 系和 KL-6 作为 IIM-ILD 严重程度标志物的作用。为此，探讨IIM-ILD患者B线评分、血清KL-6水平、高分辨率CT（HRCT）评分与肺功能检查之间的相关性。 方法：38例IIM-ILD患者接受胸部HRCT扫描、肺部超声和肺功能检查（1周内独立进行）检查。为了评估 HRCT 时 ILD 的严重程度和范围，使用了 Warrick 评分。通过对总共 50 个扫描部位的 B 线数量求和来计算表示 ILD 扩展的 B 线分数。采用化学发光酶联免疫分析法测定血清KL-6水平（U/ml）。结果：B线评分与血清KL-6水平显着相关（r = 0.43，P < 0.01），Warrick评分与血清KL-6水平显着相关（r = 0.45，P < 0.01）。还证实了 B 线评分与 Warrick 评分之间的正相关性（r = 0.87，P < 0.0001）。 B 线评分和 KL-6 水平均与一氧化碳扩散能力（分别为 r = -0.77，P < 0.0001 和 r = -0.42，P < 0.05）和总肺活量（分别为 r = -0.73，P < 0.0001 和 r = -0.36，P < 0.05）呈负相关。此外，B 线与用力肺活量 (r = -0.73，P < 0.0001)、1 秒用力呼气量 (r = -0.69，P < 0.0001) 呈负相关。结论：B 线评分和血清 KL-6 水平与 HRCT 结果和肺功能测试相关，支持将其用作 IIM-ILD 严重程度的衡量标准。
Objective: Idiopathic inflammatory myositis-associated interstitial lung disease (IIM-ILD) significantly increases morbidity and mortality. Lung ultrasound B-lines and Krebs von den Lungen-6 (KL-6) are identified as new sonographic and serum markers of ILD, respectively. The aim of our work was to assess the role of B-lines and KL-6 as markers of the severity of IIM-ILD. For this purpose, the correlation among B-lines score, serum KL-6 levels, high-resolution CT (HRCT) score, and pulmonary function tests were investigated in IIM-ILD patients.Methods: Thirty-eight patients with IIM-ILD underwent chest HRCT scans, lung ultrasound and pulmonary function tests (independently performed within 1 week) examination. To assess severity and extent of ILD at HRCT, the Warrick score was used. The B-lines score denoting the extension of ILD was calculated by summing the number of B-lines on a total of 50 scanning sites. Serum KL-6 levels (U/ml) was measured by chemiluminescent enzyme immunoassay.Results: A significant correlation was found between the B-lines score and serum KL-6 levels (r = 0.43, P < 0.01), and between the Warrick score and serum KL-6 levels (r = 0.45, P < 0.01). A positive correlation between B-lines score and the Warrick score (r = 0.87, P < 0.0001) was also confirmed. Both B-lines score and KL-6 levels inversely correlated to diffusion capacity for carbon monoxide (r = -0.77, P < 0.0001 and r = -0.42, P < 0.05, respectively) and total lung capacity (r = -0.73, P < 0.0001 and r = -0.36, P < 0.05, respectively). Moreover, B-lines correlated inversely with forced vital capacity (r = -0.73, P < 0.0001), forced expiratory volume in 1 s (r = -0.69, P < 0.0001).Conclusion: B-lines score and serum KL-6 levels correlate with HRCT findings and pulmonary function tests, supporting their use as measures of IIM-ILD severity.