Logistic回归分析评价血清免疫球蛋白预测乙型肝炎相关肝硬化  

Appraisement of Serum Immunoglobulins for Prediction of Hepatitis B Associated Cirrhosis by Binary Logistic Regression Analysis

作　　者：张占卿[1] 陆伟[1] 史连国[2] 冯艳玲[2] 

机构地区：[1]复旦大学附属公共卫生临床中心肝病科,上海201508 [2]复旦大学附属公共卫生临床中心病理科,上海201508

出　　处：《临床消化病杂志》2009年第1期34-35,共2页Chinese Journal of Clinical Gastroenterology

摘　　要：目的探讨血清免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)对乙型肝炎相关肝硬化的诊断价值。方法慢性乙型肝炎172例,其中病理诊断为肝硬化的患者28例,非肝硬化的患者144例。血清免疫球蛋白采用免疫透射比浊法测定。统计分析采用SPSS 12.0软件。肝硬化与非肝硬化患者之间血清IgG、IgA和IgM水平的比较采用两独立样本t检验;血清IgG、IgA和IgM水平诊断肝硬化的评价采用二分类Logistic回归分析。结果肝硬化患者血清IgG和IgA水平显著高于非肝硬化患者(t=4.702和3.034,P=0.000和0.003),血清IgM水平相近于非肝硬化患者(t=0.132,P=0.895)。血清免疫球蛋白中,只有IgG符合Logistic回归分析纳入自变量标准(P<0.05)。基于血清IgG建立的Logistic回归模型预测肝硬化的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为0.107、0.986、0.600、0.850、0.843。结论血清IgG可作为预测乙型肝炎相关肝硬化的一项重要指标。Objective To explore the diagnostic efficacy of serum immunoglobulins （ IgG, IgA, IgM ） for prediction of hepatitis B associated cirrhosis. Methods 172 consecutive patients were retrospectively studied,in which 28 patients and 144 patients were pathologically diagnosed as cirrhosis and non-cirrhosis. Serum immunoglobulins were determined hy immunotrbidimettic assay. SPSS 12.0 software was used for statistical analyses. Independent samples test was used for comparisons of serum IgG, IgA,IgM levels between cirrhosis and non-cirrhosis. Binary logistic regression analysis was used for appraisement of serum IgG, IgA.IgM for predicting cirrhosis. Results Serum IgG and lgA levels in patients with cirrhosis were signifieantly higher than those in patients with non-cirrhosis（ t =4. 702 and 3. 034, P =0. 000 and 0. 003） ,and serum lgM level in patients with cirrhosis was similar to that in patients with non-cirrhosis（ t =0. 132, P =0. 895）. Of the serum-immunoglobulins,only IgG accorded with the entry criterion（ P 〈 0.05 ） for logistic regression analysis. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy of the logistic regression model based on serum IgG were 0. 107, 0. 986, 0. 600, 0. 850, 0. 843. Conclusion Serum IgG is an important index for prediction of hepatitis B associated cirrhosis.

关 键 词：免疫球蛋白 慢性乙型肝炎 肝硬化 无创诊断 二分类Logistic同归分析 

分 类 号：R575.2[医药卫生—消化系统]