2nd Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
Department of Pulmonology, "Leon Daniello" Clinical Hospital of Pulmonology, 400371 Cluj-Napoca, Romania.
Medicina (Kaunas). 2024 Oct 16;60(10):1702. doi: 10.3390/medicina60101702.
Pulmonary fibrosis, including idiopathic pulmonary fibrosis (IPF) and secondary pulmonary fibrosis (SPF), is a progressive lung disease that significantly impairs respiratory function. Accurate differentiation between IPF and SPF is crucial for effective management. This study explores the association between pulmonary fibrosis and hepatic conditions, evaluating the utility of various hemogram-derived ratios and hepatic fibrosis scores in distinguishing between IPF and SPF. We conducted a retrospective study involving patients diagnosed with IPF or SPF at the "Leon Daniello" Clinical Hospital of Pneumology in Cluj-Napoca, Romania. Pulmonary fibrosis was confirmed via imaging techniques, and hepatic steatosis and fibrosis were assessed using non-invasive scores. We analyzed clinical, laboratory, and pulmonary function data, focusing on hemogram-derived ratios and hepatic scores. Statistical analyses, including ROC curves, were used to evaluate the effectiveness of these biomarkers in differentiating IPF from SPF. We included a total of 38 patients with IPF and 28 patients with SPF. Our findings revealed that IPF patients had a significantly higher FIB-4 score compared to SPF patients, suggesting increased hepatic fibrosis risk in IPF, as well as an increased RDW/PLT ratio. Conversely, SPF patients exhibited elevated PLR, PNR, and SII, reflecting a more pronounced inflammatory profile. PLR and PNR demonstrated the highest discriminatory ability between IPF and SPF, while traditional hepatic fibrosis scores showed limited differentiation capabilities. No significant differences in pulmonary function tests were observed across hepatic fibrosis risk categories. The study highlights the value of biomarkers like PLR and PNR in differentiating between IPF and SPF, offering additional diagnostic insights beyond traditional imaging. Integrating hepatic assessments into the management of pulmonary fibrosis could improve diagnostic accuracy and patient care.
肺纤维化，包括特发性肺纤维化（IPF）和继发性肺纤维化（SPF），是一种进行性肺病，严重损害呼吸功能。准确区分 IPF 和 SPF 对于有效管理至关重要。本研究探讨了肺纤维化与肝脏状况之间的关联，评估了各种血液衍生比和肝纤维化评分在区分 IPF 和 SPF 中的效用。
我们进行了一项回顾性研究，涉及罗马尼亚克卢日-纳波卡的“Leon Daniello”临床肺病医院诊断为 IPF 或 SPF 的患者。通过影像学技术确认肺纤维化，并使用非侵入性评分评估肝脂肪变性和纤维化。我们分析了临床、实验室和肺功能数据，重点关注血液衍生比和肝评分。统计分析，包括 ROC 曲线，用于评估这些生物标志物在区分 IPF 和 SPF 中的有效性。
我们共纳入 38 例 IPF 患者和 28 例 SPF 患者。我们的研究结果表明，与 SPF 患者相比，IPF 患者的 FIB-4 评分明显更高，提示 IPF 患者的肝纤维化风险增加，以及 RDW/PLT 比值增加。相反，SPF 患者表现出升高的 PLR、PNR 和 SII，反映出更明显的炎症特征。PLR 和 PNR 在区分 IPF 和 SPF 方面表现出最高的区分能力，而传统的肝纤维化评分显示出有限的区分能力。在肝纤维化风险类别中，肺功能测试没有观察到显著差异。
该研究强调了像 PLR 和 PNR 这样的生物标志物在区分 IPF 和 SPF 方面的价值，提供了超越传统成像的额外诊断见解。将肝脏评估纳入肺纤维化的管理中可以提高诊断准确性和患者护理水平。
