摘要
目的:探讨急性白血病患者血清同型半胱氨酸(homocysteine, Hcy)水平及临床意义,建立急性白血病Hcy诊断模型。方法:选择2016年8月至2018年10月于江苏省兴化市人民医院住院治疗的20例初诊急性白血病患者为研究组,同期体检中心体检的20例健康人为对照组。采用美国Beckman Coulter 公司AU5800全自动生化分析仪测定血清Hcy、胱抑素C(cystatin C, Cys C)。绘制受试者工作特征曲线(ROC)。结果:研究组血清Hcy、Cys C水平分别为(18.530 ± 8.291)μmol/L、(1.421 ± 0.887) mg/L,对照组血清Hcy、Cys C水平分别为(10.120 ± 2.220)μmol/L、(0.887 ± 0.184)mg/L,差异均有统计学意义(P = 0.000;t = 2.634, P =< 0.016)5)。血清Hcy ROC曲线下面积(Az) 0.869,标准误0.062,95%可信区间(0.724,0.954),敏感性灵敏度80%,特异性特异度90%,Youden指数为0.7。血清CysC ROC曲线下面积(Az) 0.737,标准误0.080,95%可信区间(0.575,0.864),敏感性度95%,特异性度50%,Youden指数为0.45。血清Hcy和Cys C ROC曲线面积之间(为0.131,标准误 0.066 ,95%可信区间(0.0012,0.261),P = 0.0479),差异有统计学意义。结论:研究组血清Hcy水平高于对照组,Hcy诊断模型的敏感性和特异性高于Cys诊断模型,检测血清Hcy水平在协助诊断急性白血病诊断方面有更大的临床意义。
Objective: To measure the serum homocysteine (Hcy) level in patients with acute leukemia and investigate its clinical significance, and to establish a Hcy diagnostic model for acute leukemia. Methods: A total of 20 patients with newly diagnosed acute leukemia who were hospitalized in Xinghua People's Hospital from August 2016 to October 2018 were enrolled as study group, and 20 healthy individuals who underwent physical examination in the Physical Examination Center of our hospital during the same period were selected as control group. Serum Hcy and cystatin C (CysC) levels were measured using the AU5800 automatic biochemical analyzer from Beckman Coulter Inc. in the United States. The receiver operating characteristic (ROC) curve was also plotted. Results: Serum Hcy and CysC levels were 18.530 ± 8.291 μmol/L and 1.421 ± 0.887 mg/L in the study group, and 10.120 ± 2.220 μmol/L and 0.887±0.184 mg/L in the control group;there were significant differences in the two markers between the two groups (t = 4.382, P = 0.000;t = 2.634, P = 0.016). In the diagnosis of acute leukemia, serum Hcy had an area under the ROC curve (AUC) of 0.869 (standard error: 0.062;95% confidence interval: 0.724 - 0.954), a sensitivity of 80%, a specificity of 90%, and a Youden index of 0.7;serum CysC had an AUC of 0.737 (standard error: 0.080;95% confidence interval: 0.575-0.864), a sensitivity of 95%, a specificity of 50%, and a Youden index of 0.45. There was a significant difference in AUC between serum Hcy and CysC, with a difference of 0.131 (standard error: 0.066, 95% confidence interval: 0.0012-0.261, P = 0.0479). Conclusion: Serum Hcy level was significantly higher in the study group than in the control group, and showed higher sensitivity and specificity than CysC for the diagnosis of acute leukemia. Therefore, measurement of serum Hcy level is of greater clinical significance in the diagnosis of acute leukemia.
作者
周靖泳
王娟
汤华
何美娟
张秋
周瑶
ZHOU Jingyong;WANG Juan;TANG Hua;HE Meijuan;ZHANG Qiu;ZHOU Yao(Department of Hematology B Ultrasonic Room, the Affiliated Xinghua Hospital to Kangda College of Nanjing Medical University, Xinghua 225700, Jiangsu Province, China)
出处
《西南医科大学学报》
2019年第3期238-241,共4页
Journal of Southwest Medical University
基金
泰州市科技支撑社会发展计划(指导性)项目(2016-13)
