ROC曲线及Logistic回归评价WBC、CRP、D-D、FIB在肺炎支原体感染的诊断价值  

Evaluation of Logistic regression and ROC curve on diagnostic value of serum WBC,CRP,D-D and FIB in mycoplasma pneumoniae infection

作　　者：张乐[1] 孙雯雯[1] 刘玲玲[1] ZHANG Le;SUN Wenwen;LIU Lingling(Department of Clinical Laboratory Medicine,Affiliated Shandong Provincial Hospital,Shandong University,Jinan,Shandong 250001,China)

机构地区：[1]山东大学附属省立医院临床医学检验部,济南250001

出　　处：《国际检验医学杂志》2018年第3期300-302,307,共4页International Journal of Laboratory Medicine

基　　金：山东省临床重点专科建设项目经费资助项目(鲁卫医字[2013]26号)

摘　　要：目的分析支原体肺炎患者白细胞计数(WBC)、C-反应蛋白(CRP)、D-二聚体(D-D)及纤维蛋白原(FIB)相关性并利用Logistics回归和受试者工作特征曲线(ROC)评估各项指标单独及联合检测对筛查肺炎支原体(MP)感染的应用价值。方法收集山东大学附属省立医院2015年3月至2017年3月所有检测MPDNA的患者473例,比较WBC、CRP、D-D、FIB水平,通过MP-DNA检测结果分为87例阳性组,386例阴性组。另选取同期该院100例体检健康者作为对照组。用Logistic回归模型制作ROC,并计算ROC曲线下面积以评估各项目的诊断价值。结果阳性组WBC、CRP、D-D、FIB水平明显高于对照组,差异有统计学意义(P<0.05)。各项ROC曲线下最佳临界值分别为WBC 8.51×109/L、CRP 4.94mg/L、D-D 1.135mg/L、FIB 3.39g/L;各项ROC曲线下面积分别为WBC 0.708、CRP 0.743、D-D 0.735、FIB 0.748;联合检测的约登指数为0.502、灵敏度为97.0%。结论联合检测WBC、CRP、D-D、FIB水平可在鉴别诊断MP感染中起到互补作用,提高对MP感染诊断的约登指数,有助于临床鉴别诊断和治疗。Objective To analyze the correlation among WBC,CRP,D-D,FIB in the patients with mycoplasma pneumonia,and to evaluate the application values of single and combined detection of various indicators for screening mycoplasma pneumoniae(MP)infection by using the Logistic regression and receiver operating characteristic(ROC)curve.Methods A total of 473 patients with MP-DNA detection in the Affiliated Shangdong Provincial Hospital of Shandong University from March 2015 to March 2017 were collected.The levels of WBC,CRP,D-D and FIB were compared among these cases.The cases were divided into the positive group(87 cases)and negative group(386 cases)according to the results of MP-DNA detection.Contemporaneous 100 subjects undergoing healthy physical examination were selected as the control group.The Logistic regression model was used to make ROC curve and the area under the ROC curve was calculated to evaluate the diagnostic value of each indicator.Results The levels of WBC,CRP,D-D and FIB in the positive group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).The best cutoff values under the ROC curve for various indicator were 8.51×10 9/L for WBC,4.94 mg/L for CRP,1.135 mg/L for D-D and 3.39 g/L for FIB;the areas under the ROC curve of WBC,CRP,D-D and FIB were 0.708,0.743,0.735 and 0.748 respectively;the Youden index of joint detection was 0.502 and the sensitivity reached 97.0%.Conclusion The combined detection of WBC,CRP,D-D and FIB levels play the complementary role in the differential diagnosis of MP infection,increases the Yourden index for diagnosing MP infection,and is conducive to clinical differential diagnosis and treatment.

关 键 词：肺炎支原体 C-反应蛋白 D-二聚体 纤维蛋白原 

分 类 号：R446.1[医药卫生—诊断学] R56[医药卫生—临床医学]