Narita Jun-ichi, Hasegawa Takashi, Tsuchida Masanori, Terada Masaki, Takada Toshinori, Hashimoto Takehisa, Aoki Tadashi, Tsukada Hiroki, Narita Ichiei, Hayashi Jun-Ichi, Gejyo Fumitake, Suzuki Eiichi
Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata.
Intern Med. 2006;45(9):615-9. doi: 10.2169/internalmedicine.45.1606. Epub 2006 Jun 1.
It is well known that the serum level of KL-6 can be an indicator of disease activity in patients with interstitial pneumonia (IP). However, surgical lung biopsy is often required for the diagnosis of IP, although this can result in IP exacerbation.
The effect of surgical lung biopsy on the serum level of KL-6 in patients with IP was analyzed. Thirty-two cases of IP were examined in this study. There were no cases showing exacerbation of IP.
The serum level of KL-6 demonstrated 1067+/-550 U/ml (mean+/-SD) before lung biopsy, 991+/-471 U/ml a day, 824+/-377 U/ml 4 days and 826+/-384 U/ml 7 days after lung biopsy. The serum KL-6 levels on the 1st, 4th, 7th day after the lung biopsy were significantly lower than that before the lung biopsy (P<0.05, P<0.01 and P<0.01, respectively). The percent decrease of the serum KL-6 levels on the 4th day (the lowest level) was dependent on the urine volume, and the analysis of the urinary levels of KL-6 showed a transient increase in urinary KL-6 excretion, suggesting that the decrease in serum KL-6 levels associated with surgical lung biopsy may be caused by this increase in urinary KL-6 excretion.
Surgical lung biopsy of patients with IP has little effect on the increase in serum KL-6 levels. An elevation of serum KL-6 after surgical lung biopsy may indicate exacerbation of IP.
众所周知，血清KL-6水平可作为间质性肺炎（IP）患者疾病活动的指标。然而，IP的诊断通常需要外科肺活检，尽管这可能导致IP病情加重。
分析外科肺活检对IP患者血清KL-6水平的影响。本研究检查了32例IP患者。无IP病情加重的病例。
肺活检前血清KL-6水平为1067±550 U/ml（均值±标准差），肺活检后1天为991±471 U/ml，4天为824±377 U/ml，7天为826±384 U/ml。肺活检后第1天、第4天、第7天的血清KL-6水平均显著低于肺活检前（分别为P<0.05、P<0.01和P<0.01）。第4天（最低水平）血清KL-6水平的下降百分比取决于尿量，对尿中KL-6水平的分析显示尿中KL-6排泄量短暂增加，提示与外科肺活检相关的血清KL-6水平下降可能是由尿中KL-6排泄量增加所致。
IP患者的外科肺活检对血清KL-6水平升高影响不大。外科肺活检后血清KL-6升高可能提示IP病情加重。
