嗜酸性粒细胞计数与免疫球蛋白E测定筛查华支睾吸虫病的研究

Application study on the eosinophil counts and immunoglobulin E determination for the diagnosis of clonorchiasis

目的评价嗜酸性粒细胞计数(Eos)与免疫球蛋白E(IgE)在华支睾吸虫病中的临床诊断价值,为筛查华支睾吸虫感染提供依据。方法共有66例华支睾吸虫感染者与53例健康对照者入选,检测血清IgE水平、白细胞计数(WBC)、血红蛋白量(Hb)、Eos,通过Logistic逐步回归分析,建立华支睾吸虫病诊断的统计模型,并应用受试者工作特性(ROC)曲线评价统计模型的诊断效能和临界值。结果 Eos与IgE华支睾吸虫感染组明显高于对照组,差异有统计学意义(P<0.05),而WBC与Hb两组间差异无统计学意义(P>0.05);Eos和IgE联合诊断华支睾吸虫病的ROC曲线下面积为0.884,明显高于IgE的0.814和Eos的0.783,差异有统计学意义(P<0.05),其回归方程P=1/[1+e-(-2.374+6.062Eos+0.006IgE)],当临界值为0.16,其诊断华支睾吸虫病的敏感度为100.0%,特异性为30.2%,阳性预测值为64.1%,阴性预测值为100.0%。结论联合Eos和IgE检测有助于提高华支睾吸虫病的诊断效能,明显优于单一指标的检测,而且可以排除部分真阴性标本,对降低劳动力、节约成本具有重要意义。

Objective To evaluate the value of eosinophil counts （Eos） and immunoglobulin E（IgE） levels in clinical diagnostic of the clonorchiasis. Methods 66 cases of clonorchiasis infection patients and 53 cases of health person were randomly enrolled. IgE levels in serum, white blood cell counts （WBC）, hemoglobin （Hb）, eosinophil counts were measured,with logistic stepwise regression,to establish a mathematical model for diagnosis,assess the diagnostic efficacy of the model,and calculate the diagnostic cutoff points for clonorchiasis using the ROC curve. Results Both Eos and IgE in the in clonorchiasis infection group were significantly higher than that in the control group （P〈0.05）. There were no significant difference for WBC and Hb in the two groups （P〈0.05）; The area under ROC curve（AUC） of Eos combined with IgE（0. 884） was statistically greater than IgE （0. 814） and Eos alone （0. 783）（P（0.05） according to the regression equation P= 1/[1＋e-（-2. 374＋6. 062Eos＋0. 006IgE）] ,with the cutoff point of 0.16, the sensitivity of 100 %, the specificity of 30.2 %, the positive predictive value of 64.1%, and the negative predictive value of 100〈 respectively. Conclusion The model of logistic regression is helpful to improve the diagnostic efficacy for clonorchiasis. In addition,it could significantly reduce manual work in tensive field and costs.