多指标联合检测对类风湿关节炎的临床诊断价值[J].pdf多指标联合检测对类风湿关节炎的临床诊断价值[J].pdf

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G21论G21G21著G21多指标联合检测对类风湿关节炎的临床诊断价值潘秋荣G28G23孙肖依G29G21G28G2B南京中医药大学附属常州中医院检验科G23江苏常州G29G28G26G22G22G26G2AG29G2B江苏大学京江学院医学检验系G23江苏镇江G29G28G29G22G22G22G22G21G21摘G21要G23目的G21探讨类风湿因子G21G36G5BG22G24葡萄糖G32G21G32磷酸异构酶G21G3AG35G25G22G24抗突变型瓜氨酸波形蛋白G21G39G24G47G22抗体G21抗G39G24G47G22和抗环瓜氨酸肽G21G24G24G35G22抗体G21抗G24G24G35G22联合检测对类风湿关节炎G21G36G34G22的临床诊断价值G27方法G21以G28G22G27例G36G34患者G21G36G34组G22及G27G21例非G36G34患者G21非G36G34组G22为研究对象G23检测G36G5BG24G3AG35G25G24抗G39G24G47和抗G24G24G35血清浓度G27结果G21G33个指标检测结果在G36G34组和非G36G34组间的差异有统计学意义G21G3EG28G22G2BG22G2AG22G2A任意G29项及其以上指标联合诊断G36G34的敏感度G24特异性G24阳性预测值G24阴性预测值G24诊断效率G24G45G4DG4BG4AG41G30指数G24受试者工作特征曲线下面积分别为G2CG31G2BG29G24G28G22G22G2BG22G24G28G22G22G2BG22G24G28G22G22G2BG22G24G2CG27G2BG27G24G22G2BG2CG31和G22G2BG2CG27G33G27结论G21上述G33个指标的联合检测有助于提高诊断G36G34的灵敏度和特异性G23可弥补单指标检测的不足G23从而有效避免漏诊和误诊G27关键词G23类风湿因子G2AG21葡糖G32G21G32磷酸异构酶G2AG21关节炎G23内风湿G2AG21抗突变型瓜氨酸波形蛋白抗体G2AG21抗环瓜氨酸肽抗体G21G22G23G2AG28G22G2BG26G2CG21G2CG2BG2DG2BG2EG2FG2FG30G2BG28G21G31G26G32G33G28G26G22G2BG29G22G28G28G2BG28G26G2BG22G28G21文献标识码G23G34文章编号G23G28G21G31G26G32G33G28G26G22G21G29G22G28G28G22G28G26G32G28G33G26G21G32G22G29G4DG40G2FG2DG37G31G33G31G2DG43G2CG37G35G2FG3FG3EG2DG3FG3DG2BG31G33G2FG3CG3CG2FG2EG2FG2DG2EG31G3FG33G3FG3EG3BG4FG21G50G39G23G21G2CG33G2EG31G2AG29G3AG51G2CG33G3CG2CG33G2EG31G2AG3AG3AG39G2CG33G2EG31G2BG3FG3CG38G31G33G3CG31G2CG34G33G3FG32G31G32G3FG3EG30G40G2FG35G3DG2CG2EG3FG31G3CG2CG30G2EG40G30G31G2EG31G32G3EG27G29G49G26G24G33G23G29G2EG28G21G41G24G29G25G26G27G23G2CG26G29G28G28G30G2BG31G32G27G33G34G28G31G29G34G23G35G36G2FG26G29G26G37G27G2FG2AG27G38G23G33G27G34G23G33G2CG21G36G22G27G29G2EG3AG22G23G24G36G22G26G29G31G3CG31G47G33G27G40G26G34G26G23G29G27G2FG3DG31G40G26G37G27G2FG2DG23G3CG32G26G34G27G2FG4EG35G35G26G2FG26G27G34G31G40G34G23G36G22G26G29G31G3CG31G47G33G27G40G26G34G26G23G29G27G2FG3DG31G40G26G37G27G2FG42G29G26G43G31G33G3CG26G34G2CG23G35G4FG27G29G4CG26G29G2EG21G50G26G27G29G2EG3CG24G29G28G26G22G22G26G21G36G22G26G29G27G2DG29G30G2BG31G32G27G33G34G28G31G29G34G23G35G36G2FG26G29G26G37G27G2FG2AG27G38G23G33G27G34G23G33G2CG21G50G26G29G2EG4CG26G27G29G2EG36G23G2FG2FG31G2EG31G23G35G50G26G27G29G2EG3CG24G42G29G26G43G31G33G3CG26G34G2CG21G21G22G31G29G4CG26G27G29G2EG21G50G26G27G29G2EG3CG24G29G28G29G22G22G22G21G36G22G26G29G27G29G41G2BG32G2EG30G2CG2DG2EG2AG22G2BG42G2FG2DG2EG31G43G2FG21G3BG4DG41G54G51G40G4DG42G41G3FG4EG41G3EG40G2EG30G2EG3EG53G3DG40G4BG41G4DG55G3EG4DG50G49G2EG30G41G4AG4AG41G3FG41G3EG3FG2EG4DG30G4DG55G42G4EG41G4BG50G3DG3FG4DG2EG4AG55G3DG3EG3FG4DG42G28G36G5BG29G21G4CG40G4BG3EG4DG2FG41G32G21G32G51G4EG4DG2FG51G4EG3DG3FG41G2EG2FG4DG50G41G42G32G3DG2FG41G28G3AG35G25G29G21G3DG30G3FG2EG32G50G4BG3FG3DG3FG41G4AG3EG2EG3FG42G4BG40G40G2EG30G3DG3FG41G4AG53G2EG50G41G30G3FG2EG30G3DG30G3FG2EG49G4DG4AG4FG28G3DG30G3FG2EG32G39G24G47G29G3DG30G4AG3DG30G3FG2EG32G3EG4FG3EG40G2EG3EG3EG2EG3FG42G4BG40G40G2EG30G3DG3FG41G4AG51G41G51G3FG2EG4AG41G3DG30G3FG2EG49G4DG4AG4FG28G3DG30G3FG2EG32G24G24G35G29G2EG30G3FG4EG41G4AG2EG3DG4CG30G4DG2FG2EG2FG4DG55G42G4EG41G4BG50G3DG3FG4DG2EG4AG3DG42G3FG4EG42G2EG3FG2EG2FG28G36G34G29G2BG29G2FG2EG40G3FG3CG32G21G28G22G27G3EG3DG2FG41G2FG4DG55G51G3DG3FG2EG41G30G3FG2FG56G2EG3FG4EG36G34G28G36G34G4CG42G4DG4BG51G29G21G27G21G3EG3DG2FG41G2FG4DG55G51G3DG3FG2EG41G30G3FG2FG56G2EG3FG4EG4DG4BG3FG36G34G28G30G4DG30G32G36G34G4CG42G4DG4BG51G29G21G2AG33G3EG3DG2FG41G2FG4DG55G4EG41G3DG40G3FG4EG4FG3EG4DG30G3FG42G4DG40G2FG56G41G42G41G41G30G42G4DG40G40G41G4AG3DG30G4AG4AG41G3FG41G3EG3FG41G4AG55G4DG42G2FG41G42G4BG50G3EG4DG30G3EG41G30G3FG42G3DG3FG2EG4DG30G4DG55G36G5BG21G3AG35G25G21G3DG30G3FG2EG32G39G24G47G3DG30G4AG3DG30G3FG2EG32G24G24G35G2BG3BG2FG32G35G37G2EG32G21G3BG4EG41G42G41G56G41G42G41G2FG2EG4CG30G2EG55G2EG3EG3DG30G3FG4AG2EG55G55G41G42G41G30G3EG41G2FG4DG55G3FG4EG41G2FG41G42G4BG50G40G41G53G41G40G2FG4DG55G3FG4EG41G55G4DG4BG42G51G3DG42G3DG50G41G3FG41G42G2FG49G41G3FG56G41G41G30G36G34G4CG42G4DG4BG51G3DG30G4AG30G4DG30G32G36G34G4CG42G4DG4BG51G28G3EG28G22G2BG22G2AG29G2BG3BG4EG41G2FG41G30G2FG2EG3FG2EG53G2EG3FG4FG21G2FG51G41G3EG2EG55G2EG3EG2EG3FG4FG21G51G4DG2FG2EG3FG2EG53G41G3DG30G4AG30G41G4CG3DG3FG2EG53G41G51G42G41G4AG2EG3EG3FG2EG53G41G53G3DG40G4BG41G21G4AG2EG3DG4CG30G4DG2FG3FG2EG3EG41G55G55G2EG3EG2EG41G30G3EG4FG21G45G4DG4BG4AG41G30G2EG30G4AG41G54G3DG30G4AG3DG42G41G3DG4BG30G4AG41G42G42G41G3EG41G2EG53G41G42G4DG51G41G42G3DG3FG2EG30G4CG3EG4EG3DG42G3DG3EG3FG41G42G2EG2FG3FG2EG3EG3EG4BG42G53G41G56G41G42G41G2CG31G2BG29G21G28G22G22G2BG22G21G28G22G22G2BG22G21G28G22G22G2BG22G21G2CG27G2BG27G21G22G2BG2CG31G3DG30G4AG22G2BG2CG27G33G42G41G2FG51G41G3EG3FG2EG53G41G40G4FG2BG3AG3FG33G2DG37G35G32G31G3FG33G21G24G4DG50G49G2EG30G41G4AG4AG41G3FG41G3EG3FG2EG4DG30G4DG55G3FG4EG41G55G4DG4BG42G51G3DG42G3DG50G41G3FG41G42G2FG3EG4DG4BG40G4AG4EG3DG53G41G4CG42G41G3DG3FG3EG40G2EG30G2EG3EG53G3DG40G4BG41G2EG30G3FG4EG41G4AG2EG3DG4CG30G4DG2FG2EG2FG4DG55G36G34G2BG44G2FG38G45G3FG30G3CG32G2AG42G4EG41G4BG50G3DG3FG4DG2EG4AG55G3DG3EG3FG4DG42G2DG21G4CG40G4BG3EG4DG2FG41G32G21G32G51G4EG4DG2FG51G4EG3DG3FG41G2EG2FG4DG50G41G42G3DG2FG41G2DG21G3DG42G3FG4EG42G2EG3FG2EG2FG21G42G4EG41G4BG50G3DG3FG4DG2EG4AG2DG21G3DG30G3FG2EG32G50G4BG3FG3DG3FG41G4AG3EG2EG3FG42G4BG40G40G2EG30G3DG3FG41G4AG53G2EG50G41G30G3FG2EG30G2DG21G3DG30G3FG2EG3EG4FG3EG40G2EG3EG3EG2EG3FG42G4BG40G40G2EG30G3DG3FG41G4AG51G41G51G3FG2EG4AG41G3DG30G3FG2EG49G4DG4AG2EG41G2FG21G21类风湿关节炎G28G42G4EG41G4BG50G3DG3FG4DG2EG4AG3DG42G3FG4EG42G2EG3FG2EG2FG21G36G34G29是较为常见的致畸性自身免疫性疾病G21患者发病G29年即出现不可逆转的骨关节破坏G21进而丧失运动能力G23现行的诊断标准主要为临床表现G22G63线检查以及类风湿因子G28G42G4EG41G4BG50G3DG3FG4DG2EG4AG55G3DG3EG3FG4DG42G21G36G5BG29检测G21符合此标准的患者常已出现骨关节破坏G21且G36G5B检测缺乏特异性G21不利于早期诊断和及时治疗G23因此G21寻找特异性检测指标对G36G34进行早期诊断十分必要G23笔者对G33个与G36G34相关的检测指标进行了分析G21以明确其临床诊断价值G23结果报道如下G23G24G21资料与方法G24G2BG24G21一般资料G21G28G28G29试验组G2A本院G36G34患者G28G22G27例G21其中男G26G29例G21女G31G21例G21年龄G27G21G31G27岁G21平均G28G33G2AG2BG29G69G28G2AG2BG28G29岁G2D均符合美国风湿病学会G28G2CG27G31年修订的诊断分类标准G23G28G29G29对照组G2A本院非G36G34患者G27G21例G21其中男G29G31例G21女G2AG2C例G21年龄G2CG21G31G33岁G21平均G28G33G2AG2BG2CG69G28G2AG2BG33G29岁G2D其中系统性红斑狼疮G28G2FG4FG2FG3FG41G50G2EG3EG40G4BG51G4BG2FG41G42G4FG3FG4EG41G32G50G3DG3FG4DG2FG4BG2FG21G23G44G43G29G26G22例G22系统性硬化病G28G2FG4FG2FG3FG41G50G2FG3EG40G41G42G41G4AG41G50G3DG21G23G23G3EG29G26例G21多发性肌炎G2B皮肌炎G28G51G4DG40G4FG50G4FG4DG2FG2EG3FG2EG2FG2BG4AG41G42G50G3DG3FG4DG50G4FG4DG2FG2EG3FG2EG2FG21G35G39G2BG38G39G29G2A例G22原发性干燥综合征G28G51G42G2EG50G3DG42G4FG23G2DG4DG4CG42G41G30G2FG4FG30G4AG42G4DG50G41G21G51G23G23G29G28G33例G22未分化结缔组织病G28G4BG30G4AG2EG55G55G41G42G41G30G3FG2EG3DG3FG41G4AG3EG4DG30G30G41G3EG3FG2EG53G41G3FG2EG2FG2FG4BG41G4AG2EG2FG41G3DG2FG41G21G5DG24G3BG38G29G21例G22强直性脊柱炎G28G3DG30G5AG4FG40G4DG2FG2EG30G4CG2FG51G4DG30G4AG4FG40G2EG3FG2EG2FG21G34G23G29G28G2C例G22血清阴性脊柱关节病G28G2FG41G42G4DG30G41G4CG3DG3FG2EG53G41G2FG51G4DG30G4AG4FG40G4DG3DG42G32G3FG4EG42G4DG51G3DG3FG4EG2EG41G2FG21G23G51G34G29G2C例G21均符合国内或国际相应的诊断标准G2EG28G2FG23G28G26G29健康对照组G2A本院体检健康者G2AG33例G21其中男G28G21例G22女G26G27例G21年龄G27G21G31G29岁G21平均G28G33G21G2BG21G69G28G2AG2BG31G29岁G23G24G2BG25G21仪器与试剂G21G28G28G29试剂G2A速率散射免疫比浊法G36G5B定量检测试剂盒G28西门子G21德国G29G2D双抗体夹心酶联免疫吸附法G28G41G30G58G4FG50G41G40G2EG30G5AG41G4AG2EG50G50G4BG30G4DG2FG4DG42G49G41G30G3FG3DG2FG2FG3DG4FG21G43G44G25G23G34G29葡萄糖G32G21G32磷酸异构酶G28G4CG40G4BG3EG4DG2FG41G32G21G32G51G4EG4DG2FG51G4EG3DG3FG41G2EG2FG4DG50G41G42G3DG2FG41G21G3AG35G25G29半定量检测试剂盒G28北加G21中国G29G21G3AG35G25G25G22G2BG29G22G50G4CG2BG44时判为阳性G2D抗突变型瓜氨酸波形蛋白G28G50G4BG3FG3DG30G3FG3EG2EG3FG42G4BG40G40G2EG30G3DG3FG41G4AG53G2EG50G41G30G3FG2EG30G3DG30G3FG2EG49G4DG4AG4FG21G39G24G47G29抗体G28抗G39G24G47G29G43G44G25G23G34试剂盒G28G64G36G3AG43G37G3BG43G24G21德国G29G21抗G39G24G47G25G2AG22G5DG2BG50G44时判为阳性G2D抗环瓜氨酸肽G28G3EG4FG3EG40G2EG3EG3EG2EG3FG42G4BG40G40G2EG30G3DG3FG41G4AG51G41G51G32G3FG2EG4AG41G3DG30G3FG2EG49G4DG4AG4FG21G24G24G35G29抗体G28抗G24G24G35G29G43G44G25G23G34试剂盒G28G43G4BG42G4DG2EG50G32G50G4BG30G41G21德国G29G23G28G29G29仪器G2AG3CG37G27型特种蛋白仪G28德灵G21美国G29G22G39G4DG4AG41G40G21G27G22型酶标仪G28G3CG25G64G32G36G3DG4AG21美国G29G23G24G2BG26G21方法G21各组受试对象均抽取非抗凝晨起空腹静脉血G26G50G44G21G26G22G22G22G4C离心G2AG50G2EG30G21分离血清后严格按试剂盒说明书进行G36G5BG22G3AG35G25G22抗G39G24G47和抗G24G24G35检测G23G24G2BG27G21统计学处理G21用G23G35G23G23G28G27G2BG22统计软件进行统计学分析G23根据各指标在不同浓度时诊断G36G34的灵敏度和特异性G21计算受试者操作特征曲线G28G42G41G3EG41G2EG53G41G42G4DG51G41G42G3DG3FG2EG30G4CG3EG4EG3DG42G3DG3EG3FG41G42G2EG2FG3FG2EG3EG3EG4BG42G53G41G21G36G64G24G29及G36G64G24曲线下面积G28G3DG42G41G3DG4BG30G4AG41G42G36G64G24G21G34G5DG24G29G23以G34检验分析相关比较差异G21以G3EG28G22G2BG22G2A为差异有统计学意义G23G2CG21G26G33G28G2C国际检验医学杂志G29G22G28G28年G27月第G26G29卷第G28G26期G21G25G30G3FG48G44G3DG49G39G41G4AG21G34G4BG4CG4BG2FG3FG29G22G28G28G21G47G4DG40G2BG26G29G21G37G4DG2BG28G26G25G21结G21G21果G25G2BG24G21各组G36G5BG22G3AG35G25G22抗G39G24G47和抗G24G24G35检测结果G21G33个指标检测结果在G36G34组和非G36G34组间的差异具有统计学意义G28G3EG28G22G2BG22G2AG29G23各组G36G5BG22G3AG35G25G22抗G39G24G47和抗G24G24G35检测结果见表G28G23G25G2BG25G21G36G5BG22G3AG35G25G22抗G39G24G47和抗G24G24G35诊断性能评价G21各组G33个检测指标的阳性率见表G29G21由表G29计算获得的各检测指标诊断性能评价指标结果见表G26G23表G28G21G21G36G5BG29G3AG35G25G29抗G39G24G47和抗G24G24G35检测结果G24G46G69G3CG26组别G29G36G5BG28G25G5DG2BG50G44G29G3AG35G25G28G50G4CG2BG44G29抗G39G24G47G28G5DG2BG50G44G29抗G24G24G35G28G36G5DG2BG50G44G29G36G34组G28G22G27G26G28G2AG2BG2CG69G28G28G21G2BG29G22G28G2BG29G31G69G22G2BG33G27G22G26G2AG21G2BG33G69G28G22G2AG2BG26G22G28G33G29G2BG2AG22G69G2AG28G2BG33G22非G36G34组G27G21G29G28G2BG21G69G28G28G2BG26G22G2BG33G26G69G22G2BG29G21G29G31G2BG21G69G28G28G2BG26G26G2BG33G28G69G28G2BG2AG2C健康对照组G2AG33G28G22G2BG31G69G2AG2BG2CG22G2BG28G28G69G22G2BG22G33G29G28G21G2BG27G69G33G2BG31G29G2BG22G28G69G28G2BG29G27G21G21G22G2AG3EG28G22G2BG22G2AG21与非G36G34组比较G23表G29G21G21各指标检测阳性率G27G29或G29G24G57G26G28组别G29G36G5BG32G25G4CG39G3AG35G25抗G39G24G47抗G24G24G35任意G29项或G29项以上G36G34组G28G22G27G27G29G28G31G2AG2BG2CG29G27G21G28G31G2CG2BG21G29G27G26G28G31G21G2BG2CG29G31G27G28G31G29G2BG29G29G28G22G2AG28G2CG31G2BG29G29非G36G34组G27G21G28G28G28G28G29G2BG27G29G28G33G28G28G21G2BG29G29G31G28G27G2BG28G29G2AG28G2AG2BG27G29G21G22G28G22G2BG22G29健康对照组G2AG33G29G28G26G2BG31G29G26G28G2AG2BG21G29G29G28G26G2BG31G29G28G28G28G2BG2CG29G21G22G28G22G2BG22G29表G26G21G21G36G5BG29G3AG35G25G29抗G39G24G47和抗G24G24G35诊断性能评价指标灵敏度G28G57G29特异性G28G57G29阳性预测值G28G57G29阴性预测值G28G57G29诊断效率G28G57G29G45G4D
编号:201312191611038165    类型:共享资源    大小:1.80MB    格式:PDF    上传时间:2013-12-19
  
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本文标题:多指标联合检测对类风湿关节炎的临床诊断价值[J].pdf
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