Significance Of Serum Krebs Von Den Lungen-6(KL-6) In Assessing The Severity Of Idiopathic Pulmonary Fibrosis And The Efficacy Of Oral Pirfenidone

Objective:1.To explore the significance of serum KL-6 in evaluating the severity of idiopathic pulmonary fibrosis(IPF)disease.2.The significance of serum KL-6 levels in patients with IPF treated with pafenidone in the evaluation of therapeutic efficacyMethod:1.From January 2016 to December 2018,28 patients with IPF were admitted to our department.The diagnostic criteria of IPF were 2011 edition of ATS/ERS/JRS/ALAT undefineds diagnostic guidelines for IPF.The serum KL-6,6 minute walking test,pulmonary function test and oxygenation index were measured on admission.The correlation between KL-6 and 6 minute walking test,pulmonary function test,oxygenation index and lung high resolution CT(HRCT)score was observed.The correlation between KL-6 and 6 minute walking test,pulmonary function test,oxygenation index and lung high resolution CT(HRCT)score was observed..2.In IPF group,5 patients received pirfenidone treatment as pretreatment group.Six months after oral administration of pirfenidone(1 case of oral 600 mg 3-day maintenance,1 case of oral 200 mg 3-day maintenance,3 cases of oral 400 mg 3-day maintenance),serum KL-6,pulmonary function test was recorded again,and the HRCT score was set as the post-treatment group.The above indexes before and after treatment were compared and analyzed in order to study the clinical application value of serum KL-6 in patients with IPF.Results: 1.1 There was a negative correlation between serum KL-6 level and oxygenation index in blood gas analysis in IPF patients,but there was no statistical significance(r = 0.111,P = 0.582).1.2 There was a negative correlation between serum KL-6 level and pulmonary function indexes TLC-SB% and DLCO SB% in patients with IPF,but there was no statistical significance.(r = 0.235,P = 0.28,P = 0.303,P = 0.16).1.3 There was a positive correlation between serum KL-6 level and high resolution lung CT score in patients with IPF(r = 0.785,P< 0.05).1.4 There was a negative correlation between serum KL-6 level and 6-minute walking test in patients with IPF(r = 0.709,P < 0.05).2.1 The levels of serum KL-6 in pre-treatment group and post-treatment group were significantly lower than those in pre-treatment group(996.20 ±329.33)and pre-treatment group(1340.80 ±724.79),but there was no significant difference(P =0.2).2.2 There was no significant difference in HRCT score between pre-treatment group and post-treatment group(15.6 ±3.36)compared with that of pre-treatment group(15.6 ±3.91).There was no significant difference between pre-treatment group and post-treatment group(P =1).2.3 There was no significant difference in TLC-SB% between pre-treatment group and post-treatment group(58.96 ±12.07)compared with pre-treatment group(58.96 ±11.39),and there was no significant difference between the two groups.There was no significant difference in pulmonary function between IPF patients before and after treatment(P =1).2.4 The DLCO-SB% of pulmonary function indexes before and after treatment in IPF group was significantly lower than that in post-treatment group(37.80 ±20.19)and(39.38 ±18.86),respectively.There was no significant difference between the two groups(P= 0.66).Conclusions:1.It is speculated that serum KL-6 can be used as an effective index to reflect the severity of IPF patients.2.In this experiment,KL-6 can not be used as a therapeutic effect in the treatment of oral administration of pirfenidone in patients with IPF.but due to its small sample size,short observation time,oral doses,etc.,a large sample of experiments is needed for further evaluation.