儿童葡萄糖-6-磷酸异构酶抗原检测参考范围的建立

Establishment of children′s reference value of glucose-6-phosphate isomerase antigen determination

目的建立儿童葡萄糖-6-磷酸异构酶（G6PI）抗原浓度检测的临界值。方法采用固相酶联免疫吸附试验（ELISA）检测775名正常对照者[分别按年龄（≤3岁、4-6岁、7-9岁和〉9岁）和性别（男、女）分组]及53例类风湿关节炎（RA）患儿G6PI抗原浓度。采用受试者工作特征（ROC）曲线确定G6PI的临界值。结果≤3岁、4-6岁、7-9岁和（9岁正常对照者G6PI抗原浓度分别为0.126±0.069、0.127±0.079、0.129±0.072和（0.126±0.072）mg/L,各组间差异均无统计学意义（P〉0.05）。以性别分组,男、女G6PI抗原浓度分别为0.124±0.089和（0.123±0.065）mg/L,2组间差异无统计学意义（P〉0.05）。RA组G6PI抗原浓度[（0.517±0.298）mg/L]显著高于正常对照组[（0.127±0.073）mg/L,P=0.00]。当临界值在0.27 mg/L时,G6PI抗原用于RA诊断的特异性为95.1%,敏感性为79.2%;当临界值在0.32 mg/L时,其特异性为96.2%,敏感性为65.4%。结论深圳地区儿童G6PI抗原检测当临界值在0.27和0.32 mg/L时,具有较好的诊断符合率,且无年龄、性别差异。

Objective To establish the critical value of glucose-6-phosphate isomerase（G6PI）antigen determination in children.Methods 775 healthy controls（age groups：≤3 years old,4-6 years old,7-9 years old and 9 years old;sex groups： girl and boy groups） and 53 patients with rheumatoid arthritis（RA） were enrolled.The concentration of G6PI antigen was determined by solid phase enzyme-linked immunosorbent assay（ELISA）.The critical value of G6PI antigen was analyzed by receiver operating characteristic（ROC） curve.Results The concentrations of G6PI antigen from different age groups ≤3 years,4-6 years,7-9 years and 9 years were 0.126±0.069,0.127±0.079,0.129±0.072 and（0.126±0.072） mg/L respectively.There was no statistical difference in different age groups（P0.05）.The concentrations of G6PI antigen were 0.124±0.089 and（0.123±0.065） mg/L in boy group and girl group with no statistical significance（P0.05）.The concentration of G6PI antigen in RA group [（0.517±0.298） mg/L] was higher than that in healthy group [（0.127±0.073）mg/L,P=0.00].The specificity and sensitivity were 95.1%and 79.2%,when the critical value was 0.27 mg/L.The specificity and sensitivity were 96.2%and 65.4%,when the critical value was 0.32 mg/L.Conclusions The G6PI antigen concentration of children in Shenzhen is not affected by age and sex.With good specificity and sensitivity,0.27 and 0.32 mg/L may be the high reference values for RA.