应用ROC曲线评价MIP-1α在煤工尘肺早期诊断中的价值

发布时间：2018-03-08 12:31

本文选题：煤工尘肺　切入点：趋化因子　出处：《环境与职业医学》2014年12期 　论文类型：期刊论文

【摘要】：[目的]构建受试者工作特征(ROC)曲线模型,应用ROC曲线探讨血清巨噬细胞炎症蛋白-1α(MIP-1α)在煤工尘肺病早期诊断中的价值。[方法]选择某煤业集团公司经职业健康检查的、肺部有小阴影但不够诊断为尘肺一期的180名接尘工人作为观察组,180名肺部完全正常的接尘工人作为接尘组,109名煤工尘肺一期患者作为病例组,采集空腹静脉血,使用酶联免疫吸附法测定3组研究对象血清中趋化因子MIP-1α的表达水平,采用ROC曲线对MIP-1α筛检煤工尘肺的作用进行评价。[结果]经协方差分析,控制年龄因素的影响后,病例组MIP-1α的表达水平均高于接尘组和观察组,差异均有统计学意义(P0.05),观察组MIP-1α的表达水平高于接尘组,差异有统计学意义(P0.05)。对接尘工龄分层后进行分析,结果表明病例组在10~年、20~年和30~38年3个工龄段MIP-1α表达水平均高于观察组和接尘组,差异均有统计学意义(P0.05),观察组在10~年、20~年和30~38年3个工龄段MIP-1α表达水平均高于接尘组,差异均有统计学意义(P0.05);病例组、观察组和接尘组MIP-1α表达水平随着工龄的增加有增高趋势。构建ROC曲线,曲线下面积为0.874,最佳界值为940.85 ng/L,灵敏度为75.2%,特异度为90.0%,漏诊率为24.8%、误诊率为10%、约登指数为65.2%、阳性似然比为7.52、阴性似然比为0.28、符合率为0.87、Kappa值为0.63、阳性预测值为69.49%、阴性预测值为92.31%,收益是36人。[结论]经ROC曲线评价,MIP-1α作为筛检指标具有较高的真实性和可靠性,在煤工尘肺早期诊断中具有较高的参考价值。
[Abstract]:[objective] to establish the model of roc curve, and to explore the value of serum macrophage inflammatory protein (1 伪) MIP-1 伪) in the early diagnosis of coal workers' pneumoconiosis by using ROC curve. [methods] A coal industry group company was selected for occupational health examination. 180 pneumoconiosis workers who had small shadows in their lungs but were not diagnosed as pneumoconiosis at one stage were treated as observation group, 180 workers with completely normal lungs were treated as dust exposure group, 109 coal worker pneumoconiosis patients were selected as case group, and fasting venous blood was collected. Enzyme linked immunosorbent assay (Elisa) was used to determine the expression of chemokine MIP-1 伪 in the serum of three groups of subjects, and the effect of MIP-1 伪 screening for coal worker pneumoconiosis was evaluated by ROC curve. [results] after controlling the influence of age factors, the effect of MIP-1 伪 screening on pneumoconiosis of coal workers was evaluated by the method of enzyme linked immunosorbent assay. The expression level of MIP-1 伪 in the case group was higher than that in the dust exposure group and the observation group, the difference was statistically significant (P 0.05). The expression level of MIP-1 伪 in the observation group was higher than that in the dust exposure group, and the difference was statistically significant (P 0.05). The results showed that the expression levels of MIP-1 伪 in the three working age groups were higher than those in the observation group and the dust-exposed group in 10 ~ 20 ~ and 30 ~ 38 years, and the difference was statistically significant (P < 0.05). The MIP-1 伪 expression level in the observation group was higher than that in the dust exposure group in 10 ~ 20 ~ and 30 ~ 38 years. The expression level of MIP-1 伪 in the case group, observation group and dust-exposed group increased with the increase of length of service. The ROC curve was constructed. The area under the curve is 0.874, the best threshold is 940.85 ng / L, the sensitivity is 75.2, the specificity is 90.0, the missed diagnosis rate is 24.8um, the misdiagnosis rate is 10, the Yorden index is 65.2, the positive likelihood ratio is 7.52, the negative likelihood ratio is 0.28, the coincidence rate is 0.87 Kappa value is 0.63, the positive predictive value is 69.49, the negative predictive value is 69.49, the positive likelihood ratio is 7.52, the negative likelihood ratio is 0.28, the accuracy is 0.63, the positive predictive value is 69.49. The predicted value of sex is 92.31 and the profit is 36 people. [conclusion] the ROC curve evaluation of MIP-1 伪 as screening index has high reliability and authenticity. It has high reference value in the early diagnosis of coal worker's pneumoconiosis.
【作者单位】：河北联合大学公共卫生学院;开滦职业病防治院;新乡医学院公共卫生学院;
【基金】：国家自然科学基金项目(编号:81273017) 河北省重点职业病防治技术研究项目(编号:13277709D)
【分类号】：R135.2

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