Objective To investigate the significance of serum krebs Yon den lungen-6(KL-6), surfactant protein A(SP-A), surfactant protein D(SP-D )and matrix metalloprotease 7(MMP-7) in the diagnosis of idiopathic pul-monary fibrosis (IPF) and its relationship with pulmonary function .Methods Serum levels of KL-6, SP-D, SP-A and MMP-7 were detected by ELISA in 38 patients with IPF and serum from 38 patients with pneumonia and 38 normal controls.Serum levels of markers were further analyzed by operating characteristic curve receiver (ROC), from which the ideal level of each serum marker was obtained , and the follow-up of 6 months in patients with IPF . Explore the significance of the diagnosis of IPF and its correlation with pulmonary function .Results The expres-sion of MMP-7, SP-A, SP-D and KL-6 in serum of IPF patients was higher than that in the control group and healthy control group ( P<0.05) .The optimal cutoff value of KL-6 was 723.0 U/ml, SP-A was 67.2 ng/ml, SP-D was 98.1 ng/ml, and MMP-7 was 10.1 ng/ml.The sensitivity of KL-6 was 71.1% and 98.7%, SP-A was 81.6%and 97.4%, SP-D was 81.6%and 97.4%, MMP-7 was 68.4%and 98.7%.The sensitivity of combined KL-6, SP-A, SP-D and MMP-7 four serum markers was 100%, compared with a single serum index , the P value was less than 0.05, with statistical significance .IPF patients serum SP-A, MMP-7 and forced vital capacity within 6 months were significantly correlated(r1 =-0.574,P1 <0.001;r2 =-0.465,P2 =0.003).Conclusion KL-6, SP-A, SP-D and MMP-7 were highly expressed in serum of patients with IPF , and in the diagnosis of IPF , com-bined detection of 4 serum markers can improve the early diagnosis of IPF patients .Combined serum SP-A and MMP-7 levels can improve the accuracy of the IPF patients with pulmonary function changes , the prediction of dis-ease progression has a certain significance .%目的：探讨血清Ⅱ型肺泡细胞表面抗原（ KL-6）、肺表面活性蛋白A（SP-A）、肺表面活性蛋白D（SP-D）及基质金属蛋白酶7（MMP-7）对特发性肺纤维化（IPF）的诊断意义及与肺功能的关系。方法收集38例IPF患者血清、38例肺炎患者血清及38例正常者血清标本，使用ELISA法检测KL-6、SP-A、SP-D及MMP-7的水平，对血清标记物水平按受试者工作特性曲线（ ROC）进一步分析，从中得出每种血清标记物的理想水平，并对IPF患者随访6个月，探索其对IPF的诊断意义及与肺功能的关系。结果在IPF患者血清中KL-6、SP-A、SP-D及MMP-7的表达较肺炎对照组和健康对照组高，差异有统计学意义（ P＜0.05）。 KL-6的最佳截断值为723.0 U／ml， SP-A 为67.2 ng／ml， SP-D 为98.1 ng／ml， MMP-7为10.1 ng／ml。 KL-6诊断的敏感性、特异性为71.1％、98.7％；SP-A 为81.6％、97.4％；SP-D 为81.6％、97.4％；MMP-7为68.4％、98.7％。联合 KL-6、SP-A、SP-D及MMP-7四种血清标志物的敏感性为100％，与单一血清指标比较，差异有统计学意义（ P＜0.05）。 IPF患者血清SP-A、MMP-7与用力肺活量在6个月内的变化有明显的相关性（r1＝－0.574、P1＜0.001，r2＝－0.465、P2＝0.003）。结论KL-6、SP-A、SP-D 及MMP-7在IPF 患者的血清中高表达，在IPF 患者的诊断中，四种血清标志物联合检测可提高IPF患者早期诊断的敏感性。联合血清中SP-A、MMP-7水平可提高对IPF 患者肺功能改变判断的准确性，对疾病进展的预测有一定意义。
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