血清LDH、CA153、FA和Hcy水平检测鉴别诊断MA和MDS的临床价值  

Clinical value of serum LDH,CA153,FA,and Hcy levels in differential diagnosis of MA and MDS

作　　者：李伟 魏晓婷 郭苗 赵多祥 LI Wei;WEI Xiaoting;GUO Miao;ZHAO Duoxiang(Baoji High-tech Hospital,Baoji 721013,China)

机构地区：[1]宝鸡高新医院,陕西宝鸡721013

出　　处：《临床医学研究与实践》2023年第16期90-93,共4页Clinical Research and Practice

摘　　要：目的分析乳酸脱氢酶(LDH)、糖类抗原153(CA153)、叶酸(FA)和同型半胱氨酸(Hcy)水平检测鉴别诊断巨幼细胞性贫血(MA)和骨髓增生异常综合征(MDS)的临床价值。方法以2017年12月至2020年12月在我院确诊的198例MA患者为MA组,49例MDS患者为MDS组,均进行LDH、CA153、FA、Hcy水平检测。比较两组患者的LDH、CA153、FA、Hcy水平;分析LDH、CA153、FA、Hcy单独及联合检测对MA和MDS的诊断效能。结果MA组的LDH、CA153、Hcy水平高于MDS组,FA水平低于MDS组,差异具有统计学意义(P<0.05)。LDH、CA153、FA、Hcy联合检测对MA和MDS的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值高于LDH、CA153、FA、Hcy单独检测(P<0.05)。结论LDH、CA153、FA、Hcy联合检测对MA、MDS有着较高的诊断灵敏度、特异度以及准确度,可为疾病的鉴别诊断提供参考依据,指导患者接受更加针对性的治疗,意义重大。Objective To analyze clinical value of lactate dehydrogenase(LDH),carbohydrate antigen 153(CA153),folic acid(FA)and homocysteine(Hcy)levels in the differential diagnosis of megaloblastic anemia(MA)and myelodysplastic syndrome(MDS).Methods A total of 198 MA patients diagnosed in our hospital from December 2017 to December 2020 were selected as MA group,and 49 MDS patients were selected as MDS group.LDH,CA153,FA and Hcy levels were all detected.The levels of LDH,CA153,FA and Hcy were compared between the two groups;the diagnostic efficacy of LDH,CA153,FA,Hcy alone and combined detection for MA and MDS were analyzed.Results The levels of LDH,CA153 and Hcy in the MA group were higher than those in the MDS group,while the level of FA was lower than that in the MDS group,and the differences were statistically significant(P<0.05).The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of LDH,CA153,FA and Hcy combined detection for MA and MDS were higher than those of LDH,CA153,FA and Hcy alone detection(P<0.05).Conclusion The combined detection of LDH,CA153,FA and Hcy has high diagnostic sensitivity,specificity and accuracy for MA and MDS,it can provide reference for the differential diagnosis of diseases and guide patients to receive more targeted treatment,which is of great significance.

关 键 词：乳酸脱氢酶 糖类抗原153 叶酸 同型半胱氨酸 巨幼细胞性贫血 骨髓增生异常综合征 难治性贫血 

分 类 号：R556[医药卫生—血液循环系统疾病]