脑脊液B细胞趋化因子配体13在神经梅毒诊断中的临床意义  

Clinical significance of B-cell chemokine ligand 13 in cerebrospinal fluid in the diagnosis of neurosyphilis

作　　者：殷晓云 胥萍[1] 陈慧[1] 吴敏智[1] 杨玉婷[1] 吴敏娟[1] Yin Xiaoyun;Xu Ping;Chen Hui;Wu Minzhi;Yang Yuting;Wu Minjuan(Laboratory of Suzhou Fifth People's Hospital,Suzhou 215131,China)

机构地区：[1]苏州市第五人民医院检验科,苏州215131

出　　处：《国际流行病学传染病学杂志》2024年第1期38-42,共5页International Journal of Epidemiology and Infectious Disease

基　　金：苏州市临床医学专家团队引进项目(SZYJTD201811)。

摘　　要：目的了解梅毒患者脑脊液(CSF)B细胞趋化因子配体13(CXCL13)在神经梅毒诊断中的临床价值。方法以2018年10月至2022年12月苏州市第五人民医院收治住院的208例梅毒患者为研究对象,其中确诊神经梅毒患者116例与非神经梅毒92例,收集人口统计学和疾病史等临床特征资料。采用ELISA法测CSF中趋化因子CXCL13的表达水平,并评价其诊断效能。结果神经梅毒组CSF-CXCL13水平为93.91(28.05,412.65) pg/mL,高于非神经梅毒组的5.41(3.86,25.45) pg/mL,差异有统计学意义(U=9 366.51,P<0.001)。与CSF-CXCL13表达水平<5.43 pg/mL者相比,CSF-CXCL13在5.43~31.49 pg/mL、31.50~121.44 pg/mL、和≥121.45 pg/mL的梅毒患者发生神经梅毒的风险分别增加11.14、22.74和659.40倍。ROC曲线分析显示,CSF-CXCL13诊断神经梅毒的曲线下面积达到0.89,CSF-WBC、CSF-蛋白与CSF-CXCL13联合检测诊断神经梅毒的AUC为0.93,其灵敏度为83.37%,特异性为91.42%。结论 CSF-CXCL13表达水平升高是梅毒患者发生神经梅毒风险的预测因子,对神经梅毒的早期诊断有一定参考价值。Objective To investigate the clinical value of cerebrospinal fluid(CSF)B-cell chemokine ligand 13(CXCL13)in the diagnosis of neurosyphilis in patients with syphilis.Methods A total of 208 syphilis patients admitted to Suzhou Fifth People's Hospital from October 2018 to December 2022 were enrolled in this study.Among them,116 cases were confirmed with neurosyphilis and 92 cases with non-neurosyphilis,and their demographic and clinical features were collected.The expression levels of CXCL13 in CSF were measured using enzyme-linked immunosorbent assay(ELISA),and its diagnostic value was evaluated.Results The level of CSF-CXCL13 in neurosyphilis group was 93.91(28.05,412.65)pg/mL,which was higher than that of 5.41(3.86,25.45)pg/mL in the non-neurosyphilis group,with a statistically significant difference(U=9366.51,P<0.001).Compared with patients with the level of CSF-CXCL13<5.43 pg/mL,the risk of developing neurosyphilis in patients with CSF-CXCL13 levels in the ranges of 5.43-31.49 pg/mL,31.50-121.44 pg/mL,and≥121.45 pg/mL increased by 11.14 times,22.74 times,and 659.40 times,respectively.ROC analysis showed that the area under ROC curve(AUC)of CSF-CXCL13 in diagnosing neurosyphilis reached 0.89,and the AUC of combined detection of CSF-WBC,CSF-Pro,and CSF-CXCL13 in diagnosing neurosyphilis was 0.93,with a sensitivity of 83.37%and a specificity of 91.42%.Conclusions Elevated expression levels of CSF-CXCL13 are predictive factors for the risk of neurosyphilis in syphilis patients,providing a certain reference value for the early diagnosis of neurosyphilis.

关 键 词：神经梅毒 趋化因子CXCL13 脑脊液蛋白 联合检测 预测 

分 类 号：R759.13[医药卫生—皮肤病学与性病学]