Logistic回归和ROC曲线评价EB病毒VCA-IgM及AST、ALT对EB病毒现症感染的诊断价值  

Evaluation of Logistic regression and ROC curve on diagnostic value of Epstein-Barr virus VCA-IgM,AST and ALT in Epstein-Barr virus current infection

作　　者：张培莉[1] 邵婧[1] 刘义庆[1] 陈兰兰[1] 范卫华[1] 牛登冉 段文冰[1] 

机构地区：[1]山东大学附属省立医院临床医学检验部,济南250021

出　　处：《国际检验医学杂志》2017年第6期763-765,768,共4页International Journal of Laboratory Medicine

基　　金：山东省自然科学基金(ZR2016HM52);山东省科学技术发展计划资助项目(2014GGH218041);山东省临床重点专科项目(鲁卫医字[2013]26号)

摘　　要：目的探讨EB病毒衣壳抗原IgM(VCA-IgM)、丙氨酸氨基转移酶(AST)、天门冬氨酸氨基转移酶(ALT)单项及联合检测对EB病毒现症感染的诊断价值。方法收集2016年1月至10月化学发光法测定的EB病毒VCA-IgM阳性标本。用实时荧光定量PCR法检测EB病毒DNA,酶速率法检测ALT、AST水平。将标本分成EB病毒DNA阳性组和EB病毒DNA阴性组,运用SPSS22.0对各指标进行非参数检验,通过Logistic回归和ROC曲线对各指标进行分析。结果 EB病毒DNA阳性组VCA-IgM、AST、ALT水平均高于EB病毒DNA阴性组,差异有统计学意义(P<0.05)。VCA-IgM、AST、ALT 3者均与EB病毒DNA相关(P<0.05)。VCA-IgM、AST、ALT 3者单项检测的曲线下面积(AUC)分别为0.803(95%CI:0.735~0.872)、0.788(95%CI:0.708~0.868)、0.752(95%CI:0.671~0.832),3者联合检测的AUC为0.830(95%CI:0.765~0.896),高于各指标单项检测的AUC。结论 EB病毒现症感染的相关指标中,VCA-IgM最具诊断学意义,优于AST、ALT,3者联合检测优于单项检测意义,有助于EB病毒感染及其他合并感染的诊断和防治。Objective To investigate the diagnostic value of the single detection and combined detection of Epstein-Barr virus（EBV）VCA-IgM,aspartate transaminase（AST）and alanine transaminase（ALT）in EBV current infection.Methods The VCAIgM positive simples tested by chemiluminescence from January to October 2016 were collected.EBV-DNA was detected by RTPCR.AST and ALT were detected by using the enzyme rate method.Then samples were divided into the EBV-DNA positive group and EBV-DNA negative group.SPSS22.0was used for conducting the non-parametric test.Then each indicator was analyzed by the Logistic regression and receiver operating characteristic（ROC）curve.Results The levels of VCA-IgM,AST and ALT in the EBVDNA positive group were higher than those in the EBV-DNA negative group,the difference was statistically significant（P〈0.05）.VCA-IgM,AST and ALT showed a correlation with EBV-DNA（P〈0.05）.The areas under curve（AUC）of VCA-IgM,AST and ALT single indicator detection curve were 0.803（95%CI：0.735-0.872）,0.788（95%CI：0.708-0.868）,and 0.752（95%CI：0.671-0.832）,respectively;AUC of 3-indicator combined detection were 0.830（95%CI：0.765-0.896）,which was high than AUC of each single indicator detection.Conclusion Among the indicators in EBV current infection,VCA-IgM is of great diagnostic value,and is superior to AST or ALT.Furthermore,the combined detection of these three indicators is better than single indicator detection,which contributes to the diagnosis and prevention of EBV infection and other complicating infection.

关 键 词：EB病毒 化学发光免疫分析 DNA 受试者工作特征曲线 

分 类 号：R446.6[医药卫生—诊断学]