Choe Eun Jun, Jang Ji Hoon, Park Jin Han, Jung So Young, Her Minyoung, Lee Jae Ha
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Department of Dermatology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
PLoS One. 2025 May 30;20(5):e0323784. doi: 10.1371/journal.pone.0323784. eCollection 2025.
This study evaluated the role of blood Krebs von den Lungen-6 (KL-6) in predicting acute exacerbation (AE) in patients with idiopathic pulmonary fibrosis (IPF).
From April 2018 to March 2023, clinical data of 233 IPF patients with baseline and follow-up KL-6 values at Haeundae Paik Hospital were retrospectively analyzed. AE was defined following the criteria proposed by Collard et al. in 2016.
The mean age was 71.8 years; 79% were male. During follow-up (median: 18.7 months), 33 (14.2%) patients experienced AE. Throughout the entire period from baseline, KL-6 values were higher in the AE group compared to the non-AE group (P < 0.001), and the patterns of change over time also showed significant differences between both groups (P < 0.001). The KL-6 values in the post-exacerbation phase were higher than those in the pre-exacerbation phase among the AE group (P = 0.004). The AE group showed lower 1-year (86.4% vs. 95.9%) and 3-year (50.2% vs. 91.4%) survival rates compared to the non-AE group (P < 0.001). The occurrence of AE (hazard ratio (HR) 74.09, 95% confidence interval (CI) 31.97-171.7, P < 0.001) and higher lactate dehydrogenase (HR 1.02, 95% CI: 1.01-1.02, P < 0.001) were independently associated with mortality in patients with IPF.
Our data suggest that the trend in changes in KL-6 values may be utilized as a tool for predicting AE-IPF. Further research is needed to establish the clinical significance of changes in KL-6 for predicting AE-IPF and to validate the cut-off values for prediction.
本研究评估了血液中克雷布斯-冯-登-伦根-6(KL-6)在预测特发性肺纤维化(IPF)患者急性加重(AE)中的作用。
回顾性分析了2018年4月至2023年3月在海云台白医院有基线和随访KL-6值的233例IPF患者的临床资料。AE按照Collard等人在2016年提出的标准进行定义。
平均年龄为71.8岁;79%为男性。在随访期间(中位数:18.7个月),33例(14.2%)患者发生了AE。从基线开始的整个期间,AE组的KL-6值高于非AE组(P < 0.001),两组随时间的变化模式也显示出显著差异(P < 0.001)。AE组中,加重后阶段的KL-6值高于加重前阶段(P = 0.004)。与非AE组相比,AE组的1年(86.4%对95.9%)和3年(50.2%对91.4%)生存率较低(P < 0.001)。AE的发生(风险比(HR)74.09,95%置信区间(CI)31.97 - 171.7,P < 0.001)和较高的乳酸脱氢酶(HR 1.02,95% CI:)与IPF患者的死亡率独立相关。
我们的数据表明,KL-6值的变化趋势可作为预测AE-IPF的一种工具。需要进一步研究以确定KL-6变化在预测AE-IPF中的临床意义并验证预测的临界值。 (原文中乳酸脱氢酶95%置信区间未完整给出)