摘要
目的:探讨血清免疫球蛋白G4(IgG4)临床分布特征及在IgG4相关疾病(IgG4-RD)中的诊断价值。方法:回顾性分析2018年1月—2021年12月菏泽市立医院1256例患者的临床资料,均采用增强型免疫散射法对其血清标本中的IgG4进行检测,根据测定结果和临床其他相关诊断标准,将1256例患者分为研究A组(均为IgG4-RD患者,19例)和研究B组(均为非IgG4-RD患者,1237例),利用受试者工作特征(ROC)曲线分析IgG4在IgG4-RD患者中的诊断价值;对非IgG4-RD患者按照疾病类型进行分组,比较不同疾病类型的IgG4检测水平和阳性检出率。结果:研究A组血清IgG4水平高于研究B组(P<0.05);研究A组IgG4阳性检出占比100%,高于研究B组的12.37%(P<0.05)。经ROC曲线分析显示,取最优约登指数0.899时,IgG4诊断IgG4-RD的敏感度为92.05%,特异度为89.14%,曲线下面积(AUC)为0.919[95%CI(0.879,0.965)],最佳临界值为1.95 g/L。研究B组不同疾病类型之间IgG4水平差异均有统计学意义(P<0.05),其中以肿瘤相关疾病和自身免疫疾病患者IgG4水平最高;而不同疾病类型之间IgG4阳性检出率比较差异无统计学意义(P>0.05)。结论:IgG4-RD患者多伴有血清IgG4表达异常升高的现象,可累及多组织器官;以1.95 g/L为临界值则可以提高疾病诊断的敏感度和特异度;但为了区分IgG4-RD和肿瘤相关疾病和自身免疫疾病还需结合其他临床诊断加以鉴别。
Objective:To investigate the clinical distribution of serum immunoglobulin G4(IgG4)and its diagnostic value in IgG4-related diseases(IgG4-RD).Method:A retrospective analysis was conducted on the clinical data of 1,256 patients from Heze Hospital from January 2018 to December 2021.IgG4 in their serum samples was detected by enhanced immune scattering method.According to the measurement results and other clinical diagnostic criteria,1,256 patients were divided into study group A(all IgG4-RD patients,19 cases)and study group B(all non IgG4-RD patients,1,237 cases),the diagnostic value of IgG4 in patients with IgG4-RD was analyzed by receiver operating characteristic(ROC)curve;non IgG4-RD patients were divided into groups according to the type of disease,and the detection level and positive detection rate of IgG4 in different groups were compared.Result:The serum IgG4 levels in study group A were higher than those in study group B(P<0.05);the proportion of IgG4 positive cases in study group A was 100%,which was higher than that 12.37%in study group B(P<0.05).According to ROC curve analysis,when the optimal Youden index was 0.899,the sensitivity and specificity of IgG4 for diagnosing IgG4 RD were 92.05% and 89.14%,with an area under curve(AUC)of 0.919[95%CI(0.879,0.965)].The optimal critical value was 1.95 g/L.There was a statistically significant difference in IgG4 levels among different disease types in the group B(P<0.05),patients with tumor related diseases and autoimmune diseases had the highest IgG4 levels;there was no statistically significant difference in the detection rate of IgG4 positivity among different disease types(P>0.05).Conclusion:IgG4-RD patients are often accompanied by abnormal increase of serum IgG4 expression,which may involve multiple tissues and organs,the proportion of male patients is greater than female patients.Taking 1.95 g/L as the critical value can improve the sensitivity and specificity of disease diagnosis.However,in order to distinguish IgG4-RD from tumor related diseases and autoimmune diseases,it is necessary to combine other clinical diagnosis.
作者
李睿
李翔
周阳
朱树国
LI Rui;LI Xiang;ZHOU Yang;ZHU Shuguo(Teaching and Research Section of Pathogenic Examination,Heze Medical Vocational School,Heze 274000,China;不详)
出处
《中国医学创新》
CAS
2024年第22期163-167,共5页
Medical Innovation of China
关键词
血清免疫球蛋白G4
IgG4相关疾病
临床分布特征
诊断价值
Serum immunoglobulin G4
IgG4 related diseases
Clinical distribution characteristics
Diagnostic value
