Serum surfactant protein D predicts the outcome of patients with idiopathic pulmonary fibrosis treated with pirfenidone
Serum surfactant protein D predicts the outcome of patients with idiopathic pulmonary fibrosis treated with pirfenidone
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DOI：
10.1016/j.rmed.2017.08.021
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发表时间：
2017-10-01
影响因子：
4.3
通讯作者：
Takahashi, Hiroki
中科院分区：
文献类型：
--
作者：
Ikeda, Kimiyuki;Shiratori, Masanori;Takahashi, Hiroki
背景：特发性肺纤维化（IPF）是一种预后不良的致死性肺部疾病。吡非尼酮是第一种抗纤维化药物，可抑制用力肺活量（FVC）下降，并改善部分（但不是全部）IPF患者的预后;因此，需要一种用于识别吡非尼酮治疗结局改善的指标。本研究旨在阐明基线参数是否可以预测pirfenidone.Methods治疗的IPF患者的疾病进展和预后：我们回顾性调查了2008年12月至2014年11月期间在札幌医科大学医院开始接受pirfenidone治疗的IPF患者。接受吡非尼酮治疗>6个月的患者入组本研究，并观察至2015年11月。我们调查的临床特征，肺功能检查结果，并在开始吡非尼酮与patients. Results的结果血液检查结果的关联：60例患者被纳入本研究。在多变量logistic回归分析中，%预测FVC和血清表面活性蛋白（SP）-D水平是最初12个月FVC下降>10%的预测因子。在考克斯比例风险模型中，这两个因素预测无进展生存期。Pack-years、%预测的一氧化碳弥散量和SP-D水平预测了总生存率。结论：血清SP-D水平是吡非尼酮治疗IPF患者疾病进展和预后的预测因子。此外，该分析描述了基线时其他临床参数在估计吡非尼酮治疗候选者IPF患者预后方面的相对有用性。(C)2017爱思唯尔有限公司版权所有
Background: Idiopathic pulmonary fibrosis (IPF) is a fatal pulmonary disease with poor prognosis. Pirfenidone, the first antifibrotic drug, suppresses the decline in forced vital capacity (FVC) and improves prognosis in some, but not all, patients with IPF; therefore, an indicator for identifying improved outcomes in pirfenidone therapy is desirable. This study aims to clarify whether baseline parameters can be predictors of disease progression and prognosis in patients with IPF treated with pirfenidone.Methods: We retrospectively investigated patients with IPF who started treatment with pirfenidone between December 2008 and November 2014 at the Sapporo Medical University Hospital. Patients treated with pirfenidone for >6 months were enrolled in this study and were observed until November 2015. We investigated the association of clinical characteristics, pulmonary function test results, and blood examination results at the start of pirfenidone with the outcome of patients.Results: Sixty patients were included in this study. In multivariate logistic regression analysis, % predicted FVC and serum surfactant protein (SP)-D levels were predictors of a >10% decline in FVC in the initial 12 months. In the Cox proportional hazards model, these two factors predicted progression-free survival. Pack-years, % predicted diffusing capacity for carbon monoxide, and SP-D levels predicted overall survival.Conclusions: The serum SP-D level was a predictor of disease progression and prognosis in patients with IPF treated with pirfenidone. In addition, this analysis describes the relative usefulness of other clinical parameters at baseline in estimating the prognosis of patients with IPF who are candidates for pirfenidone therapy. (C) 2017 Elsevier Ltd. All rights reserved.