血清IgG4在IgG4相关疾病中的诊断价值  

The diagnostic value of serum IgG4 in IgG4 related diseases

作　　者：吴雪 孟新艳[1] 石亚妹[1] 罗采南[1] 武丽君[1] WU Xue;MENG Xin-yan;SHI Ya-mei;LUO Cai-nan;WU Li-jun(People’s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang,Urumqi,830001,China)

机构地区：[1]新疆维吾尔自治区人民医院,乌鲁木齐830001

出　　处：《新疆医学》2021年第11期1221-1224,共4页Xinjiang Medical Journal

基　　金：国家卫生健康委科教司技术推广扶贫项目(项目编号:2019JSTG09)。

摘　　要：目的探讨血清IgG4在IgG4相关疾病中的诊断价值及以1350 mg/L为临界浓度是否适用于鉴别IgG4-RD与其他风湿免疫疾病。方法收集2013年10月至2018年12月,就诊于新疆维吾尔自治区人民医院风湿免疫科确诊IgG4-RD患者40例,Non-IgG4-RD的其他结缔组织病患者90例及健康对照组40例,收集患者年龄、性别、诊断、血清IgG4浓度等资料。采用ROC曲线确定Ig G4诊断IgG4-RD的最佳临界值。结果40例IgG4-RD患者血清IgG4浓度水平明显高于其他风湿免疫疾病组及健康对照组,对比组间存在显著差异(P<0.05),ROC分析其诊断IgG4-RD的最佳临界值为1440 mg/L,其敏感性为90.0%,特异性为80.8%,曲线下面积为0.926。以IgG4/IgG比率为0.07作为诊断临界值时,敏感性为90.0%,特异性为77.7%,曲线下面积为0.925。结论血清IgG4是诊断IgG4-RD的重要血清标志物,以1350mg/L为临界浓度可以用于IgG4-RD与其他风湿免疫疾病的鉴别。Objective To explore the diagnostic value of serum Ig G4 in Ig G4-related diseases and study whetherthe critical concentrationof 1350 mg/L is suitable for differentiating Ig G4-RD from other rheumatic immune diseases or not.Methods 40 patients with Ig G4-RD diagnosed atthedepartmentof rheumatic immunology of people’s hospital of Xinjiang Uygur Autonomous Region from October 2013 to December 2018 were collected.Other 90 CTD patients and 40 healthy people were chosen as control group.The age,gender,diagnosis results,serum Ig G4 concentration and other data were collected.The cut off levels were determined by receiver operating characteristic(ROC)curve analysis.Results The mean serum Ig G4 concentration of 40 patients with Ig G4-RD was significantly higher than that of the group with rheumatic immune diseases and healthy control group.There was a significant differencein serum Ig G4 concentration among three groups(P<0.01).The ROC curves of serum Ig G4 levels in 170 patients were analyzed.The optimal cutoff value of serum Ig G4 for a diagnosis of Ig G4-RD was 1440 mg/L,and the sensitivity and specificity were 90.0%and 80.8%,respectively.The area under the curve(AUC)was 0.926.Whenthe ratio of Ig G4/Ig G was 0.07 and was chosen as the cut-off,the sensitivity was90.0%and the specificity were 77.7%.The area under the curve(AUC)was 0.925.Conclusion The serum Ig G4 isan important index to detect Ig G4-RD diseases.The critical concentration of Ig G4 is 1350 mg/L which can be used for differentiating Ig G4-RD from other rheumatic immune diseases.

关 键 词：IGG4 IgG4相关疾病 自身免疫疾病 

分 类 号：R593.2[医药卫生—内科学]