已知急性时相蛋白 C 反应蛋白 (CRP) 与癌症和心血管疾病的不良预后相关，但其对间质性肺疾病 (ILD) 预后影响的证据有限。因此，我们着手测试基线血清 CRP 水平是否与四种不同 ILD 的死亡率相关。在这项回顾性研究中，收集了首次向皇家就诊的 ILD 患者临床测量的 CRP 水平以及基线人口统计数据和肺功能测量值。 2010年1月至2019年12月期间在布朗普顿医院进行的检查。采用Cox回归分析确定与5年死亡率的关系。研究纳入的患者为：特发性肺纤维化（IPF）n = 422例，纤维化过敏性肺炎（fHP）n = 233例、类风湿性关节炎相关 ILD (RA-ILD) n = 111 例和系统性硬化症相关 ILD (SSc-ILD) n = 86 例。近期有感染史的患者被排除在外。在两项单变量分析中，在调整年龄、性别、吸烟史、免疫抑制治疗和基线疾病严重程度后，较高的 CRP 水平与所有四个疾病组的 5 年生存期较短相关 (IPF: HR (95% CI): 1.3 ( 1.1-1.5), p = 0.003, fHP: 1.5 (1.2-1.9), p = 0.001, RA-ILD: 1.4 (1.1-1.84), p = 0.01 和 SSc-ILD: 2.7 (1.6-4.5), p < 0.001)。较高的 CRP 水平与 IPF、fHP、RA-ILD 和 SSc-ILD 的 5 年生存率降低独立相关。© 2023 作者。约翰·威利出版的《呼吸学》

The acute-phase protein C-reactive protein (CRP) is known to be associated with poor outcomes in cancer and cardiovascular disease, but there is limited evidence of its prognostic implications in interstitial lung diseases (ILDs). We therefore set out to test whether baseline serum CRP levels are associated with mortality in four different ILDs.In this retrospective study, clinically measured CRP levels, as well as baseline demographics and lung function measures, were collected for ILD patients first presenting to the Royal Brompton Hospital between January 2010 and December 2019. Cox regression analysis was used to determine the relationship with 5-year mortality.Patients included in the study were: idiopathic pulmonary fibrosis (IPF) n = 422, fibrotic hypersensitivity pneumonitis (fHP) n = 233, rheumatoid arthritis associated ILD (RA-ILD) n = 111 and Systemic Sclerosis associated ILD (SSc-ILD) n = 86. Patients with a recent history of infection were excluded. Higher CRP levels were associated with shorter 5-year survival in all four disease groups on both univariable analyses, and after adjusting for age, gender, smoking history, immunosuppressive therapy and baseline disease severity (IPF: HR (95% CI): 1.3 (1.1-1.5), p = 0.003, fHP: 1.5 (1.2-1.9), p = 0.001, RA-ILD: 1.4 (1.1-1.84), p = 0.01 and SSc-ILD: 2.7 (1.6-4.5), p < 0.001).Higher CRP levels are independently associated with reduced 5-year survival in IPF, fHP, RA-ILD and SSc-ILD.© 2023 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.