特发性肺纤维化预后标志物的研究进展

特发性肺纤维化（IPF）是一种纤维化型间质性肺疾病，该疾病进展快、预后差、中位生存期短，严重危害患者健康。在病程早期准确评估IPF患者预后，有助于加强疾病管理、改善患者结局，因此IPF的预后评估是该病诊疗的重要一环。近年来与IPF预后相关的标志物不断涌现，良好的预后标志物能够协助判断IPF患者的危险分层与结局。因此本文从蛋白、基因、微生物菌落、细胞等方面总结了既往研究中发现的IPF可能的预后标志物，提示基质蛋白酶7(MMP-7)、端粒长度（TL）和纤维细胞是较为可靠的IPF预后标志物。涎液化糖链抗原6(KL-6)、表面活性蛋白A(SP-A)、MUC5B基因启动子单核苷酸多态性（SNP）等生物标志物的预后价值存在争议，有待进一步研究。潜在转化生长因子结合蛋白2(LTBP-2)、血管生成素2(Ang-2)、TOLLIP启动子SNP、微生物菌落等预后标志物的研究相对较少，预后作用有待验证。本文能够为临床早期识别高危患者、及时把握干预时机提供更加客观的指标，为今后IPF的预后研究提供参考。

Prognostic Biomarkers in Idiopathic Pulmonary Fibrosis: a Recent Review

Idiopathic pulmonary fibrosis (IPF) is a fibrotic interstitial lung disease characterized by rapid progression, poor prognosis, and short median survival, seriously endangering patients' health. Early accurate prediction of the prognosis is an important part of the diagnosis and management process of IPF, which is conducive to the improvement of management and prognosis in IPF. A growing number of prognostic biomarkers for IPF have been discovered recently, and those with a high prognostic value could help to stratify prognostic risks and assess outcomes. We reviewed the latest literature about potential prognostic biomarkers of IPF, involving proteins, genes, microbial colonies and cells, and considered matrix metalloproteinase-7, telomere length and fibrocytes to be more reliable, while the prognostic values of Krebs von den lungen-6, surfactant protein A, and MUC5B promoter single nucleotide polymorphism are controversial and need to be further studied, and those of latent-transforming growth factor β-binding protein-2, angiopoietin-2, TOLLIP promoter SNP and microbial colony remain to be verified due to little evidence. It is hoped that our review could provide a reference for clinical selection of objective indicators for early identifying high-risk patients and timely initiating treatment, as well as future prognostic research on IPF.