应用ROC曲线确定MPAIA在血吸虫病诊断中的最佳临界值  

Determination of best cut off value of magnetic particle antibody of immunoassay (MPAIA) in diagnosis of schistosomiasis by receiver operating characteristic (ROC) curve analysis

作　　者：陈仕明 黄进[2] 姚蓝[2] 刘锦明 莫义刚 陈大桥 蔡爱玲 苏生杰 魏兰英[2] 方正明[2] 姜昌富[2] 

机构地区：[1]湖北省荆州市第三人民医院,荆州434100 [2]华中科技大学同济医学院病原生物学系 [3]湖北省荆州市沙市区血吸虫病预防控制所

出　　处：《中国血吸虫病防治杂志》2010年第4期360-363,共4页Chinese Journal of Schistosomiasis Control

摘　　要：目的运用ROC曲线确定磁分离酶联免疫法(MPAIA)在血吸虫病临床免疫诊断中的最佳临界值。方法选择湖北省荆州市部分居民,用病原学和MPAIA方法同时对该人群进行检查。同时采用MPAIA方法对确诊的钩虫病、囊尾蚴病、旋毛虫病及乙肝患者的血清进行检测。用ROC曲线确定MPAIA在血吸虫病诊断中的最佳临界值。结果共检测549人,有疫水接触史的224人中,病原学检测阳性79人,MPAIA检测阳性92人;无疫水接触史的185人中,病原学检测均为阴性,MPAIA检测阳性2人。MPAIA法检测钩虫病、囊尾蚴病、旋毛虫病与乙肝患者血清均为阴性。ROC曲线确定血吸虫病诊断的最佳临界值为0.403(550nm),曲线下面积为0.923。结论 MPAIA在血吸虫病诊断中的最佳临界值为0.403(550nm),但应结合专业知识及实际情况来确定临床最佳临界值。Objective To evaluate the diagnostic value of the magnetic particle antibody of immunoassay （MPAIA） for schistosomiasis using the receiver operating characteristic （ROC） curve analysis and determine the optimal threshold.Methods A total of 549 persons were examined with the miracidium hatching method and MPAIA in Jingzhou City,Hubei Province.At the same time,the cases with hookworm disease,cysticercosis,trichinosis,and hepatitis B in schistosomiasis non-endemic areas were examined with MPAIA as the control.All the results were analyzed statistically with ROC curve analysis.Results In 224 persons who had the history of infested water contacting,92 cases were positive in MPAIA,among whom 79 cases were positive in the miracidium hatching method.In 185 persons who had no history of infested water contacting,all were negative in the miracidium hatching method,while 2 cases were positive in MPAIA.All the cases with hookworm disease,cysticercosis,trichinosis,and hepatitis B were negative in MPAIA.When the cut off point was 0.403 （550 nm）,the corresponding Youden index was the biggest,and the area under the ROC curve was 0.923.Conclusions The optimum threshold of MPAIA in the diagnosis of schistosomiasis is 0.403（550 nm）,but the determination of the optimum threshold in clinic should combine with the actual situation and professional knowledge.

关 键 词：血吸虫病 磁微粒分离酶联免疫法 ROC曲线 临界值 

分 类 号：R532.21[医药卫生—内科学]