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纤维化间质性肺疾病急性加重期生存预测生物标志物的回顾性分析:西班牙的一项单中心研究

Retrospective Analysis of Predictive Biomarkers of Survival in Acute Exacerbation of Fibrosing Interstitial Lung Disease: A Single-Center Study in Spain.

作者信息

Ferreiro-Posse Antía, Granados Galo, Salvador Sara, Pilia Maria Florencia, Espejo David, Romero Christian, Ojanguren Iñigo, Muñoz Xavier, Villar Ana

机构信息

Department of Respiratory Medicine, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain.

Department of Respiratory Medicine, University Hospital Vall d'Hebron, 08035 Barcelona, Spain.

出版信息

J Clin Med. 2025 Mar 14;14(6):1974. doi: 10.3390/jcm14061974.

DOI:10.3390/jcm14061974
PMID:40142785
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11942987/
Abstract

: Fibrosing interstitial lung diseases can evolve into acute exacerbations, which significantly impact morbidity and mortality. Currently, no routinely used clinical biomarkers can discern the potential progression in these patients. This study aims to analyze different biological markers used in routine clinical practice as possible predictive biomarkers for patients with acute fibrosing interstitial lung disease exacerbation. : We conducted a retrospective, single-center study including patients diagnosed with acute exacerbation of fibrosing interstitial lung disease who required hospitalization between 2018 and 2019 at Vall d'Hebron Hospital, Spain. Patient demographics, clinical data, respiratory function, and comorbidities were collected at baseline. The primary outcome was survival at 30 days, 90 days, and 365 days, using Kaplan-Meier survival analysis and Cox regression. : Twenty-nine patients were included (mean age 70.4 years). At the 3-month follow-up, patients with ischemic heart disease showed higher survival rates ( = 0.02). Identifying an infection as the etiology of the exacerbation was associated with worse one-year survival rates compared to idiopathic cases ( = 0.03). Elevated levels of leukocytes ( < 0.01), neutrophils ( < 0.01), and fibrinogen ( = 0.03) were predictors of mortality. Additionally, patients who received a cumulative dose of corticosteroids between 501 and 1000 mg during the exacerbation showed higher one-year survival ( < 0.01). : Routine clinical markers can help predict outcomes in AE-f-ILD. Further multicenter studies should validate these findings and assess the role of therapies in its management.

摘要

纤维化间质性肺疾病可演变为急性加重,这对发病率和死亡率有显著影响。目前,尚无常规使用的临床生物标志物能够识别这些患者的潜在病情进展。本研究旨在分析常规临床实践中使用的不同生物标志物,作为急性纤维化间质性肺疾病加重患者可能的预测性生物标志物。

我们进行了一项回顾性单中心研究,纳入了2018年至2019年期间在西班牙瓦尔德希伯伦医院因纤维化间质性肺疾病急性加重而需要住院治疗的患者。在基线时收集患者的人口统计学资料、临床数据、呼吸功能和合并症。主要结局是30天、90天和365天的生存率,采用Kaplan-Meier生存分析和Cox回归分析。

纳入了29例患者(平均年龄70.4岁)。在3个月的随访中,患有缺血性心脏病的患者生存率较高(P = 0.02)。与特发性病例相比,将感染确定为加重的病因与较差的一年生存率相关(P = 0.03)。白细胞水平升高(P < 0.01)、中性粒细胞水平升高(P < 0.01)和纤维蛋白原水平升高(P = 0.03)是死亡率的预测因素。此外,在加重期间接受累积剂量501至1000毫克皮质类固醇治疗的患者一年生存率较高(P < 0.01)。

常规临床标志物有助于预测AE-f-ILD的结局。进一步的多中心研究应验证这些发现,并评估治疗在其管理中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b129/11942987/1b180b8fbaa7/jcm-14-01974-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b129/11942987/fb6f5076cb22/jcm-14-01974-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b129/11942987/1b180b8fbaa7/jcm-14-01974-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b129/11942987/fb6f5076cb22/jcm-14-01974-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b129/11942987/1b180b8fbaa7/jcm-14-01974-g002.jpg

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本文引用的文献

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Respir Res. 2023 Dec 7;24(1):307. doi: 10.1186/s12931-023-02614-z.
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The Role of Cytokines in Cholesterol Accumulation in Cells and Atherosclerosis Progression.
细胞因子在细胞胆固醇蓄积和动脉粥样硬化进展中的作用。
Int J Mol Sci. 2023 Mar 29;24(7):6426. doi: 10.3390/ijms24076426.
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