SAA、CRP和ESR联合检测诊断AECOPD的临床价值  

Combined determination of SAA,CRP and ESR in the diagnosis of AECOPD

作　　者：付海卫 孔一名 李小波 张添威 戴元荣[2] FU Haiwei;KONG Yiming;LI Xiaobo;ZHANG Tianwei;DAI Yuanrong(Department of Respiratory Medicine,Huangyan Hospital,Wenzhou Medical University,Taizhou 318020,Zhejiang,China;Department of Respiratory,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China)

机构地区：[1]温州医科大学附属黄岩医院呼吸内科,浙江台州318020 [2]温州医科大学附属第二医院呼吸科,浙江温州325027

出　　处：《检验医学》2018年第7期586-589,共4页Laboratory Medicine

摘　　要：目的探讨血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)与红细胞沉降率(ESR)联合检测诊断慢性阻塞性肺疾病急性加重期(AECOPD)的价值。方法选取100例AECOPD患者,根据病情的严重程度分为AECOPDⅠ级组(44例)和AECOPDⅡ/Ⅲ级组(56例),以50名体检健康者作为正常对照组。检测所有对象的SAA、CRP和ESR水平,采用Logistic回归分析和受试者工作特征(ROC)曲线评估SAA、CRP和ESR单项检测和联合检测诊断AECOPD的价值。结果正常对照组、AECOPDⅠ级组和AECOPDⅡ/Ⅲ级组SAA、CRP和ESR水平依次升高,各组间比较差异均有统计学意义(P<0.05)。ROC曲线分析显示,SAA、CRP、ESR单项检测诊断AECOPD的曲线下面积(AUC)分别为0.835、0.906、0.873,敏感性分别为79.98%、80.54%、83.54%,特异性分别为85.65%、87.78%、78.76%,准确性分别为86.76%、79.76%、82.13%,Youden指数分别为0.66、0.68、0.62;SAA、CRP、ESR联合检测诊断AECOPD的AUC为0.949,敏感性为96.65%,特异性为92.35%,准确性为90.34%,Youden指数为0.89。结论 SAA、CRP和ESR联合检测诊断AECOPD具有较高的敏感性和特异性,可用于AECOPD的诊断。Objective To study the role of serum amyloid A(SAA),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)combined determination in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 100 AECOPD patients were enrolled and classified into AECOPDⅠgroup(44 cases)and AECOPDⅡ/Ⅲgroup(56 cases)according to the severity of AECOPD.Totally,50 healthy subjects were enrolled as control group.The levels of SAA,CRP and ESR were determined.Logistic regression and receiver operating characteristic(ROC)curve were used to analyze the diagnosis efficiency of SAA,CRP and ESR single determinations and combined determination.Results The levels of SAA,CRP and ESR in control,AECOPDⅠand AECOPDⅡ/Ⅲgroups increased in turn(P<0.05).ROC curve analysis showed that the area under curve(AUC)of SAA,CRP and ESR single determinations were 0.835,0.906 and 0.873,the sensitivities were 79.98%,80.54%and 83.54%,the specificities were 85.65%,87.78%and 78.76%,the accuracies were 86.76%,79.76%and 82.13%,and the Youden indices were 0.66,0.68 and 0.62,respectively.The AUC of SAA,CRP and ESR combined determination for the diagnosis of AECOPD was 0.949,the sensitivity was 96.65%,the specificity was 92.35%,the accuracy was 90.34%,and the Youden index was 0.89.Conclusions SAA,CRP and ESR combined determination has high sensitivity and specificity for the diagnosis of AECOPD.

关 键 词：淀粉样蛋白A C反应蛋白 红细胞沉降率 慢性阻塞性肺疾病急性加重期 

分 类 号：R446.1[医药卫生—诊断学]