双能CT联合血清IL-1β检测在痛风诊断中的应用价值  

Clinical application of dual energy CT imaging and IL-1β in diagnosis of gout

作　　者：吴春叶[1] 龚宝琪[2] 屈瑾[2] 李巍[2] WU Chun-ye;GONG Bao-qi;QU Jin;LI Wei(Department of Immunity,the 254th Hospital of the Chinese People’s Liberation Army,Tianjin 300142,China;Department of Immunity,Tianjin First Center Hospital)

机构地区：[1]中国人民解放军第254医院免疫科,300142 [2]天津市第一中心医院风湿免疫科

出　　处：《天津医药》2018年第8期869-872,共4页Tianjin Medical Journal

基　　金：天津市卫生计生委科技基金(2015KZ024)

摘　　要：目的研究双能CT(DECT)成像、血清白细胞介素(IL)-1β在痛风诊断中的应用价值。方法抽取2015年6月—2016年6月天津市第一中心医院风湿免疫科门诊及住院的有关节肿痛并明确诊断为痛风患者(痛风组)76例,另抽取40例非痛风患者做为对照组,其中类风湿关节炎33例,骨关节炎7例。DECT检测所有入选患者的受累关节,获取患者存在绿色结晶沉积的数目及堆积部位;采用酶联免疫吸附法(ELISA)检测2组患者血清IL-1β水平。评价DECT和IL-1β诊断通风的临床价值,绘制IL-1β的受试者工作特征(ROC)曲线并计算曲线下面积(AUC),确定最佳诊断界值。结果 DECT共发现尿酸盐沉积病灶349处,主要位于第1跖趾关节(245处),对照组5例患者出现假阳性,3例为甲周伪影,2例为足垫伪影。DECT诊断痛风性关节炎的敏感度和特异度分别为100%和87.5%,血清IL-1β的敏感度和特异度为65.7%和90.0%,两者联合检测敏感度及特异度是100%和95.0%。IL-1β的AUC为0.929(0.882～0.977),最佳诊断界值为5 ng/L。结论 DECT联合血清IL-1β检测有助于早期诊断痛风,明确尿酸盐沉积部位,具有较高的临床应用价值。Objective To study the value of dual energy computed tomography(DECT)imaging and serum interleukin-1β(IL-1β)levels in the diagnosis of gout.Methods A total of 76 patients with gout treated in immunity department of Tianjin First Center Hospital from June 2015 to June 2016 were included in this study(gout group).Another 40 non-gout patients including 33 cases with rheumatoid arthritis and 7 cases with osteoarthritis were served as control group.DECT were used to detect the damaged joints of patients,and confirm the number and the position of uratecrystal.Enzyme-linked immunosorbent assay(ELISA)was used to detect the serum levels of IL-1βin two groups.Receiver operating characteristic(ROC)curves of IL-1βwere plotted to determine the area under the curve(AUC)and the best cutoff value.Results DECT scan found 349 lesions with urate deposition,mainly located at the first metatarsophalangeal joint(n=245).Five false-positive patients were detected in control group,in which 3 were perionychia pseudoshadow and 2 were foot pad pseudoshadow.The sensitivity and specificity of DECT were 100%and 87.5%,while which of IL-1βwere 65.7%and 90.0%.The sensitivity and specificity of combined detection DECT and IL-1βwere 100%and 95.0%.The AUC measured by IL-1βwas 0.929(0.882-0.977),and the best cut-off value of the indicator was 5 ng/L.Conclusion DECT combined with serum IL-1βdetection can help for the early diagnosis of gout,and accurately location of uric acid,which has high clinical value.

关 键 词：痛风 白细胞介素1Β 诊断 双能CT 

分 类 号：R589.7[医药卫生—内分泌]