[1]李晨,汤庆.血清IgG4 在IgG4 相关性疾病中水平表达差异及实验诊断价值研究[J].现代检验医学杂志,2023,38(05):171-174+204.[doi:10.3969/j.issn.1671-7414.2023.05.032]
　LI Chen,TANG Qing.Differential Expression Levels and Experimental Diagnostic Value of Serum IgG4 in IgG4 Related Diseases[J].Journal of Modern Laboratory Medicine,2023,38(05):171-174+204.[doi:10.3969/j.issn.1671-7414.2023.05.032]
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血清IgG4 在IgG4 相关性疾病中水平表达差异及实验诊断价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年05期
页码:
171-174+204
栏目:
检验与临床
出版日期:
2023-09-15

文章信息/Info

Title:
Differential Expression Levels and Experimental Diagnostic Value of Serum IgG4 in IgG4 Related Diseases
文章编号:
1671-7414（2023）05-171-05
作者:
李晨; 汤庆
（华中科技大学同济医学院附属同济医院检验科，武汉 430030）
Author(s):
LI Chen;  TANG Qing
（Department of Clinical Laboratory, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030，China）
关键词:
免疫球蛋白G4; IgG4 相关性疾病; 自身免疫性疾病
分类号:
R593.2；R446.62
DOI:
10.3969/j.issn.1671-7414.2023.05.032
文献标志码:
A
摘要:
目的 探讨血清免疫球蛋白（immunoglobulin, Ig）G4 在IgG4 相关性疾病（IgG4-related disease，IgG4-RD）中水平表达差异及与疾病累积器官范围的相关性。方法 回顾性分析2020 年1 月～ 2022 年1 月于华中科技大学同济医学院附属同济医院收治并确诊为自身免疫性疾病（autoimmune disease，AID）的患者140 例作为研究对象。根据是否确诊为IgG4-RD 将患者分为IgG4-RD 组（n=63）及其他AID 组（n=77）。收集患者的临床资料，采集患者静脉血并检测其血液中血清IgG4，嗜酸性粒细胞绝对值（EO）、血红蛋白（HGB）、血细胞比容（HCT）、平均血小板体积（MPV）、凝血酶时间（TT）、总蛋白（TP）、血清肌酐（CR）、纤维蛋白原（FIB）、活化部分凝血活酶时间（APTT）以及乳酸脱氢酶（LDH）水平。利用受试者工作特征（receiver operating characteristic, ROC）曲线及Z 检验分析评价IgG4 及其他指标对IgG4-RD 与其他AID 进行鉴别诊断的价值；通过相关性分析评估IgG4 表达水平对IgG4-RD 累计器官范围的指示意义。结果 IgG4-RD 组和其他AID 组中血清IgG4，EO，HGB，HCT，MPV，TT，TP，CR，FIB，APTT 和LDH 表达水平比较，差异均有统计学意义（Z=2.02 ～ 8.32，均P<0.05）。当IgG4-RD 诊断临界值取血清IgG4 ≥ 1.35g/L 时，IgG4-RD 组的阳性率为88.89%；IgG4-RD 诊断临界值取血清IgG4 ≥ 2.01 g/L 时，IgG4-RD 组的阳性率为80.95%，两种情况下IgG4-RD 组的阳性率均明显高于其他AID 组，差异有统计学意义(χ2=57.44，54.89，均P<0.001)。ROC 曲线显示，当血清IgG4=1.53 g/L，Youden 指数最大，此诊断临界值的敏感度和特异度分别为88.89%，76.62%，曲线下面积（area under curve，AUC）为0.909 5。相关性分析结果显示，患者血清IgG4 水平与疾病累积器官范围呈正相关（r = 0.852 9）。结论 IgG4 表达水平与IgG4-RD 累积器官范围呈正相关，可作为反映IgG4-RD 严重程度的指标之一。
Abstract:
Objective To investigate the differential expression of serum immunoglobulin (Ig) G4 in IgG4 related diseases (IgG4 RD) and its correlation with the cumulative organ range of the disease. Methods A retrospective analysis was conducted on 140 patients diagnosed with autoimmune disease (AID) admitted to Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2020 to January 2022. Patients were divided into IgG4-RD group (n=63) and other AID groups (n=77) based on whether they were diagnosed with IgG4-RD. The clinical data of patients were collected. The venous blood of patients was collected and their serum IgG4, eosinophil absolute value (EO), hemoglobin (HGB), hematocrit (HCT), mean platelet volume (MPV), thrombin time (TT), total protein (TP), serum creatinine (CR), fibrinogen (FIB), activated partial thromboplastin time (APTT) and lactate dehydrogenase (LDH) levels were measured. Evaluate the value of IgG4 and other indicators in differential diagnosis between IgG4-RD and other AIDs using receiver operating characteristic (ROC) curve and Z-test analysis and evaluate the indicative significance of IgG4 expression levels on the cumulative organ range of IgG4-RD through correlation analysis. Results Comparison of serum IgG4, EO, HGB, HCT, MPV, TT, TP, CR, FIB, APTT and LDH expression levels between the IgG4-RD group and other AID groups showed statistically significant differences (Z=2.02 ～ 8.32, all P<0.05). When the critical value of IgG4-RD diagnosis was taken as serum IgG4 ≥ 1.35 g/L, the positive rate of the IgG4- RD group was 88.89%, and when the diagnostic threshold of IgG4-RD was taken as serum IgG4 ≥ 2.01 g/L, the positive rate of the IgG4-RD group was 80.95%. In both cases, the positive rate of the IgG4-RD group was significantly higher than that of other AID groups, and the difference was statistically significant（χ2=57.44, 54.89, all P<0.001). The ROC curve shows that when serum IgG4=1.53 g/L, the Youden index was the highest, with a sensitivity and a specificity was 88.89%, 76.62% for this diagnostic thresholds. the area under curve (AUC) was 0.909 5, and the correlation analysis results showed a positive correlation between the patien’s serum IgG4 level and the cumulative organ range of the disease (r=0.852 9). Conclusion The expression level of IgG4 was positively correlated with the organ range of IgG4-RD accumulation, and can be used as one of the indicators reflecting the severity of IgG4-RD.

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备注/Memo

备注/Memo:
作者简介：李晨（1991-），男，本科，临床检验技师，主要从事临床检验工作，E-mail：768819767@qq.com。
通讯作者：汤庆，男，硕士，副主任技师，主要从事临床检验工作，E-mail：tangqingmed@163.com。
更新日期/Last Update: 2023-09-15