Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
Institute of Respiratory Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
Lung. 2024 Jun;202(3):245-255. doi: 10.1007/s00408-024-00702-5. Epub 2024 May 14.
As a biomarker of alveolar-capillary basement membrane injury, Krebs von den Lungen-6 (KL-6) is involved in the occurrence and development of pulmonary diseases. However, the role of the KL-6 in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has yet to be elucidated. This prospective study was designed to clarify the associations of the serum KL-6 with the severity and prognosis in patients with AECOPD.
This study enrolled 199 eligible AECOPD patients. Demographic data and clinical characteristics were recorded. Follow-up was tracked to evaluate acute exacerbation and death. The serum KL-6 concentration was measured via an enzyme-linked immunosorbent assay.
Serum KL-6 level at admission was higher in AECOPD patients than in control subjects. The serum KL-6 concentration gradually elevated with increasing severity of AECOPD. Pearson and Spearman analyses revealed that the serum KL-6 concentration was positively correlated with the severity score, monocyte count and concentrations of C-reactive protein, interleukin-6, uric acid, and lactate dehydrogenase in AECOPD patients during hospitalization. A statistical analysis of long-term follow-up data showed that elevated KL-6 level at admission was associated with longer hospital stays, an increased risk of future frequent acute exacerbations, and increased severity of exacerbation in COPD patients.
Serum KL-6 level at admission is positively correlated with increased disease severity, prolonged hospital stay and increased risk of future acute exacerbations in COPD patients. There are positive dose-response associations of elevated serum KL-6 with severity and poor prognosis in COPD patients. The serum KL-6 concentration could be a novel diagnostic and prognostic biomarker in AECOPD patients.
作为肺泡-毛细血管基底膜损伤的生物标志物，Krebs von den Lungen-6（KL-6）参与了肺部疾病的发生和发展。然而，KL-6 在慢性阻塞性肺疾病急性加重（AECOPD）患者中的作用尚未阐明。本前瞻性研究旨在阐明血清 KL-6 与 AECOPD 患者严重程度和预后的相关性。
本研究纳入了 199 例符合条件的 AECOPD 患者。记录了人口统计学数据和临床特征。通过随访来评估急性加重和死亡。通过酶联免疫吸附试验测定血清 KL-6 浓度。
AECOPD 患者入院时血清 KL-6 水平高于对照组。AECOPD 患者的血清 KL-6 浓度随着疾病严重程度的增加而逐渐升高。Pearson 和 Spearman 分析显示，AECOPD 患者住院期间血清 KL-6 浓度与严重程度评分、单核细胞计数以及 C 反应蛋白、白细胞介素-6、尿酸和乳酸脱氢酶的浓度呈正相关。对长期随访数据的统计分析表明，入院时升高的 KL-6 水平与住院时间延长、未来频繁急性加重的风险增加以及 COPD 患者急性加重的严重程度增加相关。
入院时血清 KL-6 水平与疾病严重程度增加、住院时间延长以及 COPD 患者未来急性加重风险增加呈正相关。升高的血清 KL-6 与 COPD 患者的严重程度和不良预后呈正相关剂量反应关系。血清 KL-6 浓度可能是 AECOPD 患者的一种新的诊断和预后生物标志物。
