Abstract
Objective To investigate the effect of 25-hydroxyvitamin D[25(OH)D]levels on the degree of diffusion dysfunction in patients with pulmonary fibrosis(PF).Methods A total of 81 patients diagnosed with PF admitted to the General Hospital of Ningxia Medical University from January 2020 to June 2023 were selected as the research objects.According to the Chinese Expert Consensus on the Diagnostic Criteria of Lung Function in Adults,patients with carbon monoxide diffusion capacity(DLCO%pred)≥60%were included in the normal + mild diffusion dysfunction group(DN group,64 cases),and patients with DLCO%pred<60%were included in the moderate to severe diffusion dysfunction group(DD group,17 cases).The clinical data of all patients were collected and compared,including length of hospital stay,number of hospitalizations,white blood cell count(WBC),neutrophil percentage(NEUT),lymphocyte percentage(LYM),monocyte percent-age(M),red blood cell count(RBC),hemoglobin(Hb)level,platelet count(PLT)level,prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)level,thrombin time(TT),D-dimer(D-D)level,partial pressure of oxygen(PO2),partial pressure of carbon dioxide(PCO2),forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC,peak expiratory flow(PEF),25(OH)D,DLCO.Multivariate Logistic regression was used to analyze the risk factors affecting the degree of PF dif-fusion dysfunction.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of 25(OH)D,FVC alone and the combination of the two indexes for the severity of PF diffusion dys-function.The patients were divided into vitamin D deficiency group and vitamin D non-deficiency group ac-cording to the optimal cut-off value of ROC curve between 25(OH)D index and the severity of diffusion dys-function in PF patients,and Kaplan-Meier survival curve analysis was performed.Results NEUT,length of hospital stay,WBC,D-D level in DN group were lower than those in DD group,PT was shorter than that in DD group,FEV1,FVC,PEF,M,25(OH)D level in DN group were higher than those in DD group,the differ-ences were statistically significant(P<0.05).There was no significant difference in LYM,RBC,PLT,APTT,TT,PO2,PCO2,number of hospitalizations,FEV1/FVC,Hb level,and FIB between the two groups(P>0.05).Multivariate Logistic regression analysis showed that decreased FVC,decreased 25(OH)D level,and prolonged length of hospital stay were independent risk factors for severe diffusion dysfunction in PF pa-tients(P<0.05).The area under the curve(AUC)of 25(OH)D and FVC alone in the diagnosis of severe PF diffusion dysfunction were 0.723 and 0.828 respectively,which were lower than the 0.888 of the combined detection of the two indicators(P<0.05).According to the optimal cut-off value in ROC curve between ser-um 25(OH)D level and the degree of diffusion dysfunction in PF patients,PF patients with serum 25(OH)D<12.20 nmol/L were included in the vitamin D deficiency group(24 cases).PF patients with serum 25(OH)D≥12.20 nmol/L were included in the vitamin D non-deficiency group(57 cases).Kaplan-Meier sur-vival curve analysis showed that the length of hospital stay was 10.77 days in the vitamin D deficiency group and 9.03 days in the non-vitamin d deficiency group,with a statistically significant difference between the two groups(P<0.05).Conclusion 25(OH)D can be used to determine the degree of diffusion dysfunction in PF patients,and it can be used as a new drug for the treatment of PF and provide clinicians with more drug op-tions.关键词
肺间质纤维化/25-羟维生素D/肺功能/病例对照研究/影响因素Key words
pulmonary interstitial fibrosis/25-hydroxyvitamin D/pulmonary function/case-control study/influencing factor分类
医药卫生
