血清铁蛋白在儿童系统性红斑狼疮的诊断价值及判断病情活动的意义  

Significance of Serum Ferritin in Its Diagnostic Value and Determination of Disease Activity in Children with Systemic Lupus Erythematosus

作　　者：刘洋[1] 叶春风[1] 

机构地区：[1]南昌大学第二附属医院儿内科,南昌330006

出　　处：《实用儿科临床杂志》2012年第21期1647-1648,1657,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的研究血清铁蛋白(SF)在儿童SLE的诊断价值及判断疾病活动性的意义。方法收集本院2004-2010年63例确诊SLE的患儿为观察组,同时随机收集本院同期其他疾病患儿(感染性疾病、肿瘤、其他结缔组织病)60例为对照组,采用化学发光法检测各组血清SF水平,并进行统计学分析。结果儿童SLE活动期SF水平高于静止期及对照组(P<0.01)。SLE活动期患儿的SF水平高于正常值,且45.2%的患儿高达正常值5倍以上,SLE活动期组SF水平升高的概率,包括超过正常值、达正常值5倍以上及达正常值10倍以上,与其他2组比较差异均有统计学意义(P<0.05);SF对儿童SLE诊断价值的ROC曲线下面积为0.511(95%CI 0.407～0.614),提示SF对诊断SLE仅有较低准确性;SF判断SLE活动性的ROC曲线下面积为0.949,提示SF对判断SLE疾病活动具有重要价值,并选取了4个比较有意义的判断SLE活动性的截断点:当SF=766.5 mg.L-1、835.0 mg.L-1、860.0 mg.L-1、901.5 mg.L-1时,敏感性分别为100.0%、96.9%、96.9%和93.8%,特异性分别为83.9%、90.3%、93.5%和93.5%。结论 SF对儿童SLE无诊断意义,SF对判断狼疮活动性具有较高的价值,SF=860.0 mg.L-1可能是一个比较好的判断狼疮疾病活动的界值。Objective To investigate the diagnostic value of serum ferritin and its significance of determining the disease activity in children with systemic lupus erythematosus（SLE）. Methods The serum ferritin levels of 63 children with SLE and 60 children with other diseases（infectious diseases,cancer,and other connective tissue diseases） were measured by means of chemiluminescence.The data were analyzed. Results The serum ferritin levels were higher in children with activive SLE than those in other 2 groups（P0.01）.Moreover,the le-vel of serum ferritin in activive group were higher than normal level and the level of serum ferritin in 45.2% children of activity group was as much as 5-fold higher than the normal level.The probability of increased serum ferritin level,including higher than normal level,up to 5 times higher than normal level and up to 10 times higher than normal level,the difference with the other groups was statistical difference（P0.05）;if the area under curve of receiver operator characteristic curve（ROC） was 0.511（95% confidence interval was 0.407-0.614）,it showed serum ferritin diagnosis for SLE in children was not quite valuable;when the area under the ROC curve of activity SLE was 0.949,which indicated that SF level in activity SLE children was very important.Meanwhile,four cut-off levels of serum ferritin level for the determination of activity SLE were selected based on clinical practice and ROC curve.When the cut-off levels of serum ferritin were 766.5 mg·L^-1,835.0 mg·L^-1,860.0 mg·L^-1 and 901.5 mg·L^-1,the sensitivity for the diagnosis were 100.0%,96.9%,96.9%,and 93.8%,respectively,and the specificity were 83.9%,90.3%,93.5% and 93.5%,respectively. Conclusions Serum ferritin is not valuable for the diagnosis of active SLE in children,however serum ferritin is valuable for the determination of activity SLE and 860.0 mg·L^-1 may be a good cut-off level.

关 键 词：血清铁蛋白 系统性红斑狼疮 病情活动 诊断 儿童 

分 类 号：R725.9[医药卫生—儿科]