IgG4、IgG4/IgG、IgG4/IgG1在米库利兹病中的诊断价值  

Diagnostic Value of IgG4,IgG4/IgG,IgG4/IgG1 in Mikulicz Disease

作　　者：王瑛 蒋筠婓 WANG Ying;JIANG Yunfei(The Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201999,China;不详)

机构地区：[1]上海交通大学医学院附属第九人民医院,上海201999

出　　处：《中外医学研究》2023年第12期132-136,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究IgG4、IgG4/IgG、IgG4/IgG1在米库利兹病(MD)中的诊断价值。方法:回顾性选取2015年3月—2022年3月上海交通大学医学院附属第九人民医院收治的20例MD患者及30例原发性干燥综合征(PSS)患者。将MD患者纳入MD组,PSS患者纳入PSS组。两组均进行IgG亚类检测及抗核抗体(ANA)、抗SSA抗体和抗SSD抗体阳性率检测。比较两组IgG1、IgG2、IgG3、IgG4及IgG水平及IgG4浓度升高发生率,ANA、抗SSA抗体、抗SSB抗体阳性率,比较两组IgG亚类比值(IgG1/IgG、IgG2/IgG、IgG3/IgG、IgG4/IgG及IgG4/IgG1),分析IgG4、IgG4/IgG及IgG4/IgG1对MD的诊断价值。结果:MD组IgG2、IgG4、IgG水平均高于PSS组,IgG1水平低于PSS组,差异有统计学意义(P<0.05)。MD组IgG4浓度升高发生率高于对照组(χ^(2)=38.437,P=0.000)。MD组IgG4/IgG、IgG4/IgG1均高于PSS组,IgG1/IgG、IgG3/IgG均低于PSS组,差异有统计学意义(P<0.05)。PSS组ANA、抗SSA抗体及抗SSB抗体阳性率均高于MD组,差异有统计学意义(P<0.05)。IgG4/IgG、IgG4/IgG1诊断MD的AUC值均高于IgG4(Z=3.627、2.515,P=0.003、0.004)。结论:IgG4、IgG4/IgG及IgG4/IgG1均在MD的诊断中具有良好的效能,但IgG4/IgG及IgG4/IgG1诊断效能优于IgG4,临床可将上述指标作为MD诊断的辅助指标。Objective:To investigate the diagnostic value of IgG4,IgG4/IgG,IgG4/IgG1 in Mikulicz disease(MD).Method:A total of 20 patients with MD and 30 patients with primary Sjögren syndrome(PSS)who admitted to the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from March 2015 to March 2022 were retrospectively selected.Patients with MD were included in MD group and patients PSS were included in PSS group.IgG subclasses and positive rates of antinuclear antibody(ANA),anti-SSA antibody and anti-SSD antibody were detected in both groups.The levels of IgG1,IgG2,IgG3,IgG4 and IgG,the incidence of IgG4 concentration elevation,the positive rates of ANA,anti-SSA antibody and anti-SSB antibody were compared between the two groups,the ratio of IgG subclasses(IgG1/IgG,IgG2/IgG,IgG3/IgG,IgG4/IgG and IgG4/IgG1)were compared between the two groups,the diagnostic value of IgG4,IgG4/IgG and IgG4/IgG1 in MD were analyzed.Result:The levels of IgG2,IgG4 and IgG in MD group were higher than those in PSS group,and the level of IgG1 was lower than that in PSS group,and the differences were statistically significant(P<0.05).The incidence of IgG4 concentration elevation in MD group was higher than that in control group(χ^(2)=38.437,P=0.000).IgG4/IgG and IgG4/IgG1 in MD group were higher than those in PSS group,and IgG1/IgG and IgG3/IgG were lower than those in PSS group,and the differences were statistically significant(P<0.05).The positive rates of ANA,anti-SSA antibody and anti-SSB antibody in PSS group were higher than those in MD group,and the differences were statistically significant(P<0.05).The AUC values of IgG4/IgG and IgG4/IgG1 in the diagnosis of MD were higher than those of IgG4(Z=3.627,2.515,P=0.003,0.004).Conclusion:IgG4,IgG4/IgG and IgG4/IgG1 all have good efficacy in the diagnosis of MD,but the diagnostic efficacy of IgG4/IgG and IgG4/IgG1 are better than that of IgG4,the above indicators can be used as auxiliary indicators in the diagnosis of MD.

关 键 词：米库利兹病 IGG4 IGG 原发性干燥综合征 诊断价值 

分 类 号：R593.2[医药卫生—内科学]