MDS与MA患者临床特征差异及胆红素、α-HBDH、CA153、乳酸脱氢酶在其鉴别诊断中的价值  

Differences in Clinical Characteristics Between MDS and MA Patients and the Value of Bilirubin,α-HBDH,CA153 and LDH in Their Differential Diagnosis

作　　者：陆阳 马良 李世伦 LU Yang;MA Liang;LI Shilun(Department of Laboratory Medicine,Luohe Hospital of Traditional Chinese Medicine,Luohe 462000,China)

机构地区：[1]漯河市中医院检验科,河南漯河462000

出　　处：《河南医学研究》2023年第9期1601-1604,共4页Henan Medical Research

摘　　要：目的 探究胆红素(BILI)、α-羟丁酸脱氢酶(α-HBDH)、糖类抗原153(CA153)、乳酸脱氢酶(LDH)在骨髓增生异常综合征(MDS)、巨幼细胞性贫血(MA)鉴别诊断中的诊断价值。方法 回顾性分析漯河市中医院2019年1月至2021年8月收治的MDS(43例)与MA(47例)患者的临床资料,另选取同期健康体检的60例患者作为健康对照组。比较3组患者的临床特征,比较BILI、α-HBDH、CA153、LDH水平,通过受试者工作特征(ROC)曲线分析其诊断价值。结果 MDS组较MA组感染、出血的发生率高,贫血发生率低(P<0.05)。MDS组与MA组BILI、α-HBDH、CA153及LDH水平高于对照组,MA组BILI、α-HBDH、CA153及LDH水平高于MDS组(P<0.05)。BILI、α-HBDH、CA153及LDH诊断MDS的曲线下面积(AUC)分别为0.760、0.988、0.995、0.947,表明BILI具有一定的诊断准确性,α-HBDH、CA153及LDH的诊断准确性较高。BILI、α-HBDH、CA153及LDH诊断MA的AUC分别为0.921、0.925、0.994、0.991,均处于准确性较高的水平。BILI、α-HBDH、CA153及LDH区分MDS与MA的AUC分别为0.722、0.801、0.847、0.962,表明BILI、α-HBDH、CA153具有一定的诊断准确性,而LDH诊断准确性较高。结论 BILI、α-HBDH、CA153及LDH在MDS和MA患者中表达异常,且均对鉴别MDS与MA具有较好的敏感度,能够为临床诊治提供依据。Objective Explore bilirubin(BILI),α-hydroxybutyrate dehydrogenase(α-HBDH),carbohydrate antigen 153(CA153),lactate dehydrogenase(LDH)in the differential diagnosis of myelodysplastic syndrome(MDS),megaloblastic anemia(MA).Methods Clinical data of 43 MDS and 47 MA patients admitted to Luohe Hospital of Traditional Chinese Medicinefrom January 2019 to August 2021 were retrospectively analyzed,and another 60 patients who underwent physical examinations during the same period were selected as the health control group.The clinical characteristics and the levels of BILI,α-HBDH,CA153,LDH of three groups of patients were compared,and their diagnostic value were analyzed through the receiver operating characteristic(ROC)curve.Results The incidence of infection and bleeding in the MDS group was higher than that in the MA group,while the incidence of anemia was lower(P<0.05).The levels of BILI,α-HBDH,CA153,LDH in MDS group and MA group were higher than those in the control group,and the levels of BILI,α-HBDH,CA153,LDH in MA group were higher than those in the MDS group(P<0.05).The area under curve(AUC)of BILI,α-HBDH,CA153 and LDH in diagnosing MDS were 0.760,0.988,0.995 and 0.947,respectively,indicating that BILI had certain diagnostic accuracy,andα-HBDH,CA153,LDH were relatively high.The AUC of BILI,α-HBDH,CA153 and LDH in diagnosing MA were 0.921,0.925,0.994,0.991,respectively,they all at a high level of accuracy.The AUC of BILI,α-HBDH,CA153 and LDH in distinguishing MDS from MA were 0.722,0.801,0.847,and 0.962,respectively,indicating that BILI,α-HBDH,CA153 had certain diagnostic accuracy,while LDH had higher diagnostic accuracy.Conclusion BILI、α-HBDH,CA153 and LDH are abnormally expressed in patients with MDS and MA,and all of them have good sensitivity in distinguishing MDS and MA,which can provide basis for clinical diagnosis and treatment.

关 键 词：骨髓增生异常综合征 巨幼细胞性贫血 胆红素 Α-羟丁酸脱氢酶 糖类抗原153 乳酸脱氢酶 

分 类 号：R733.3[医药卫生—肿瘤]