体温、IL-2R、PT和LDL-C 4项指标在缺血型青年烟雾病患者中的联合鉴别诊断价值  

The Combined Value of Body Temperature,IL-2R,PT and LDL-Cin the Differential Diagnosis of Young Ischemic MoyamoyaDisease Patients

作　　者：韩冰清 于丹葳 马瑞敏[1] 刘杰 HAN Bingqing;YU Danwei;MA Ruimin;LIU Jie(Laboratory Diagnosis Center,Beijing Tiantan Hospital,Capital Medical University/Beijing Engineering Research Center of Immunological Reagents Clinical Research/NMPA Key Laboratory for Quality Control ofIn Vitro Diagnostics,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院实验诊断中心,北京市免疫试剂临床工程技术研究中心,国家药监局体外诊断试剂质量控制重点实验室,北京100070

出　　处：《标记免疫分析与临床》2024年第11期1997-2002,2050,共7页Labeled Immunoassays and Clinical Medicine

基　　金：北京市自然科学基金青年项目(编号:7244329)。

摘　　要：目的综合分析临床基线资料、基本体征指标和实验室检查指标在不同临床类型青年烟雾病(Moyamoya disease,MMD)患者中的鉴别诊断价值。方法回顾性分析首都医科大学北京天坛医院神经内科青年MMD住院患者缺血型43例、出血型34例、无症状型31例的基本体征、25项实验室相关检测指标及临床基线资料,比较不同临床类型青年MMD患者间各项指标差异,采用受试者工作特征曲线和多因素Logistic回归分析考察其在疾病中影响及鉴别性能。结果缺血型青年MMD患者体温、SBP、DBP、IL-2R、GLU、B-WBC和B-NEUT较高,PT、CHO、HDL-C和LDL-C较低;出血型青年MMD患者B-WBC、B-NEUT、LDH较低,CHO和LDL-C较高;差异具有统计学意义(P<0.05)。其中体温、IL-2R是发生缺血事件的风险因素(P<0.05),PT、LDL-C是青年MMD发生缺血事件的保护因素(P<0.05);LDH是发生出血事件的保护性因素(P<0.05)。体温、IL-2R、PT和LDL-C 4项指标联合鉴别诊断缺血型青年MMD的AUC为0.762,灵敏度为77.50%,特异性为63.33%。结论体温和IL-2R的升高、PT和LDL-C的降低与青年MMD患者发生缺血事件密切相关,联合检测对缺血型青年MMD患者具有较好的鉴别诊断效能。Objective To evaluate the value of clinical baseline data,basic signs and routine laboratory tests in the differential diagnosis of young patients with Moyamoya disease(MMD).Methods The basic signs,25 laboratory tests and clinical baseline data of 43 cases of ischemic,34 cases of hemorrhagic and 31 cases of asymptomatic MMD inpatients in the Department of Neurology of Beijing Tiantan Hospital of Capital Medical University were retrospectively analyzed.The differences of various indicators among different clinical types of young MMD patients were identified and evaluated.The influence and differential diagnostic performance were investigated by using receiver operating characteristic curve and multiple logistic regression analysis.Results The body temperature,SBP,DBP,IL-2R,GLU,B-WBC and B-NEUT were higher in young ischemic MMD patients,while PT,CHO,HDL-C and LDL-C were lower.B-WBC,B-NEUT,LDH were lower,CHO and LDL-C were higher in young hemorrhagic MMD patients.All differences above were statistically significant(P<0.05).Body temperature and IL-2R were risk factors(P<0.05),and PT and LDL-C were protective factors for ischemic events in young MMD(P<0.05).LDH was a protective factor for hemorrhagic events(P<0.05).AUC of the combined diagnostic model of body temperature,IL-2R,PT and LDL-C was 0.762,with the sensitivity of 77.50%,and the specificity of 63.33%.Conclusion The elevated body temperature serum level of IL-2R,along with the decreased serum level of PT and LDL-C,are closely related to the occurrence of ischemic events in young MMD patients.The combined diagnostic model can effectively distinguish the ischemic young MMD patients with other clinical types.

关 键 词：烟雾病 鉴别诊断 脑卒中 临床事件 

分 类 号：R743[医药卫生—神经病学与精神病学]