血清IL-6、hs-CRP和PTH联合检测在急、慢性肾衰竭鉴别诊断中的价值

发布时间：2018-04-10 21:33

本文选题：白介素- + 超敏C反应蛋白　；参考：《中国老年学杂志》2017年17期

【摘要】：目的探讨联合检测白介素(IL)-6、超敏C反应蛋白(hs-CRP)和甲状旁腺素(PTH)对急性肾衰竭(ARF)与慢性肾衰竭(CRF)鉴别诊断的价值。方法 226例肾衰竭(RF)患者分为ARF组64例,CRF组162例,再随机选取其他非肾衰竭的肾病(NRF)组84例和健康对照组80例,检测并比较4组的IL-6、hs-CRP及PTH水平,用受试者工作特征曲线(ROC)找出各标志物的临床诊断界值,串联分析各组合(IL-6+hs-CRP、IL-6+PTH、hs-CRP+PTH和IL-6+hs-CRP+PTH)的诊断效率,用矩阵决策法选择最适合鉴别诊断ARF和CRF的组合。结果 ARF组的IL-6和hs-CRP显著高于CRF与对照组(P0.01),而PTH显著低于CRF组(P0.01)。CRF组的IL-6、hs-CRP和PTH与对照组比较差异有统计学意义(P0.01)。串联分析后IL-6+hs-CRP组合可明显提高ARF的总符合率(TCR)及Youden指数(YI),而灵敏度(SE)、特异度(SP)、阳性预测值(PPV)处于理想水平;PTH单项比联合检测更能保持CRF的SE、SP、PPV、TCR及YI处于理想水平。结论 IL-6、hs-CRP和PTH联合检查有助于ARF与CRF的鉴别诊断。
[Abstract]:Objective to investigate the value of combined detection of interleukin-6, hypersensitive C-reactive protein hs-CRP and parathyroid hormone (PTH) in the differential diagnosis of acute renal failure (ARF) and chronic renal failure (CRF).Methods 226 patients with renal failure were divided into ARF group (n = 64) and non-renal failure group (n = 162). The levels of IL-6hs-CRP and PTH were measured and compared in other non-renal failure nephropathy group (n = 84) and healthy control group (n = 80).The clinical diagnostic threshold value of each marker was found by using the operating characteristic curve of subjects. The diagnostic efficiency of IL-6 hs-CRP IL-6 PTHHs-CRP PTH and IL-6 hs-CRP PTHs was analyzed in series. The combination of ARF and CRF was selected by matrix decision method.Results the levels of IL-6 and hs-CRP in ARF group were significantly higher than those in CRF group and control group (P 0.01), while the level of PTH in CRF group was significantly lower than that in CRF group (P 0.01) and PTH in CRF group was significantly lower than that in control group (P 0.01).Conclusion the combined detection of IL-6 hs-CRP and PTH is helpful to the differential diagnosis of ARF and CRF.
【作者单位】：四川省人民医院城东病区检验科;
【基金】：国家高技术研究发展计划资助项目(863计划,2014AA022304)
【分类号】：R446.6;R692.5

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