ROC曲线评价T细胞亚群、PLT、ESR和CRP在川崎病早期诊断中的应用

Evaluation of T cell subgroup,platelet counts,erythrocyte sedimentation rate and C-reactive protein for early diagnosis of Kawasaki disease by using ROC curve

目的观察T细胞亚群、血小板计数(PLT)、红细胞沉降率(ESR)和C反应蛋白(CRP)在川崎病(KD)患者中的变化,运用ROC曲线分析它们在KD早期诊断中的价值。方法2008年本院收治的KD患儿33例(实验组)和具有相似体征的非KD患儿34例(对照组),于入院3d内分别测定T细胞亚群、PLT、ESR和CRP,并观察其ROC曲线特征。结果实验组的CD3+、CD3+CD4+、CD3+CD8+测定值分别为:(67.2±9.42)%、(39.0±9.93)%、(24.8±7.42)%;对照组的CD3+、CD3+CD4+、CD3+CD8+测定值为:(65.1±12.6)%、(38.2±10.8)%、(24.3±8.42)%,两组之间比较差异无统计学意义(P>0.05)。实验组的PLT、ESR和CRP测定值分别为:(406.2±167.3)×109/L、56.0(59.5)mm/h、21.0(60.2)mg/L;对照组PLT、ESR和CRP测定值分别为:(284.7±105.9)×109/L、12.0(18.75)mm/h、8.0(10.5)mg/L,其差别均具有统计学意义(P<0.05)。实验组PLT、ESR和CRP的ROC曲线下面积(AUC)分别为:71.2%、89.1%、70.2%;诊断界值分别为:336.5×109/L、15.0mm/h、14.5mg/L。结论T细胞亚群在KD早期的变化不明显,其诊断可靠性较低;而PLT、ESR和CRP分别在336.5×109/L、15.0mm/h、14.5mg/L时具有较好的诊断效力,能作为KD早期诊断的观察指标。

Objective To observe the change of T cell subgroup, platelet counts, erythrocyte sedimentation rate and C reactive protein in children with Kawasaki disease, and to evaluate the value for early diagnosis by using ROC curve. Methods 33 children with Kawasaki disease and 34 children with the same syndromes non-Kawasaki disease were selected as the experimental group and control group. T cell subgroup, platelet counts, erythrocyte sedi- mentation rate and C-reactive protein were tested within two days after hospitalized; meanwhile the feature of ROC curves was observed. Results There was no significant difference between the Kawasaki disease group and control group about CD3＋ ,CD3＋ CD4＋ and CD3＋ CD8＋ （P〈0.05）. The platelet counts, erythrocyte sedimentation rate and C reactive protein in experimental group were significantly higher than that of the control group（P（0.05）. The area under ROC curves of PLT, ESR and CRP were 71.2%, 89. 1 %, 70. 2% respectively, while the best cut--off value was 336.5 ×10^9/L, 15.0mm/h, 14.5mg/L respectively. Conclusion There were no significant changes in T cell subgroup, with less validity for the early diagnosis of Kawasaki disease, while platelet counts, erythrocyte sedimentation rate and C-reactive protein could be used as effective items for early diagnosis of Kawasaki disease.