血清铁蛋白在全身型幼年特发性关节炎中的诊断价值

Diagnostic Value of Serum Ferritin for Systemic Juvenile Idiopathic Arthritis

目的探讨血清铁蛋白(SF)在全身型幼年特发性关节炎(SJIA)中的诊断价值。方法 30例SJIA患儿(SJIA组)及28例普通呼吸道感染患儿(对照组),在治疗前均采用放射免疫法测定其SF水平,仪器采用德国DATE BAHR IHG铁蛋白分析仪,并同时测定其CRP及ESR。SJIA组于病情缓解后再次抽血复查以上指标。采用SPSS 11.5软件进行统计学分析。结果 SJIA患儿SF水平明显高于对照组,差异有统计学意义(P<0.01)。SF>正常值5倍的例数,2组比较差异有统计学意义(P<0.01)。以SF>正常值5倍为诊断SJIA的临界值,其敏感性为83.33%,特异性为92.85%,阳性预测值92.59%。2组ESR、CRP水平比较差异均无统计学意义(Pa>0.05)。经治疗后,SJIA组30例患儿病情缓解,其SF、ESR、CRP水平均较治疗前显著降低,治疗前后比较,差异均有统计学意义(Pa<0.01)。结论 SF对诊断SJIA具有重要临床意义,以SF>正常值5倍作为诊断SJIA的临界值可较好地兼顾敏感性和特异性。SF亦可作为监测SJIA患儿病情活动度及指导治疗的指标。

Objective To explore the diagnostic value of serum ferritin（SF） for systemic juvenile idiopathic arthritis（SJIA）.Methods Thirty children with SJIA（SJIA group） and 28 children with common respiratory infection（control group） were studied.Before therapy,serum concentration of SF from venous blood samples were measured by radioimmunoassay,C-reactive protein（CRP） and erythrocyte sedimentation rate（ESR） were detected from all children by German DATE BAHRIHG.The tests were done again in SJIA group after remission.Statistical analysis were performed by using SPSS 11.5 software.Results SF in SJIA group was higher than that in the control group（P0.01）.With respect to the number of patients whose SF was more than 5 times the normal value,there was a significance between 2 groups（P0.01）.If the criteria for the diagnosis of SJIA were SF above 5 times the normal value,the sensitivity was 83.33%,specificity was 92.85%,and positive predictive value was 92.59%.There were no differences in ESR,CRP between 2 groups（Pa0.05）.The levels of SF,ESR and CRP after treatment in SJIA group were lower than those in pretreatment（Pa0.01）.Conclusions SF has important clinical significance in the diagnosis of SJIA.As a diagnostic threshold of SJIA,SF over 5 times the normal value may well take into account of sensitivity and specificity.SF is not only a diagnostic index in SJIA,but also helpful to determine the efficacy and guide treatment.