载脂蛋白M对细菌性肺炎的诊断和病情严重程度的判断价值

Value of serum APOM concentration for diagnosis of bacterial pneumonia and judgment of disease severity

目的探讨血清载脂蛋白M(APOM)浓度对细菌性肺炎的诊断以及病情严重程度的评估价值。方法采用双抗体夹心ELISA法检测250例肺炎患者及50例健康对照组的血清APOM浓度,利用ROC曲线分析其对细菌性肺炎的诊断价值,并采用Bayes判别分析方法构建基于血清APOM浓度的判别方程,评价其对细菌性肺炎严重程度的判别意义。结果细菌性肺炎组的血清APOM浓度(28.9±10.5)μg/mL显著高于病毒性肺炎组(19.4±8.93)μg/mL、其他肺炎组(16.4±5.62)μg/mL和健康对照组(18.1±6.15)μg/mL,差异有统计学意义(P<0.01)。血清APOM浓度在细菌性肺炎诊断中的ROC曲线面积可达0.843,具有良好的特异度和灵敏度。此外,血清APOM浓度与细菌性肺炎严重程度呈正相关,基于其与性别、年龄、收缩压、体温和心率几个指标构建的判别方程可较好地对细菌性肺炎的严重程度进行分类,准确度可达86.7%。结论血清APOM浓度在细菌性肺炎的诊断和疾病严重程度的评估中具有重要的临床价值。

Objective To investigate the value of serum apolipoprotein M（APOM）concentration in the diagnosis of bacterial pneumonia and its disease severity evaluation.Methods The serum APOM concentration was examined in 250 cases of pneumonia and 50 healthy controls by using the double antibody sandwich ELISA.The ROC curve was used to evaluate the diagnostic value of APOM on bacterial pneumonia and the Bayes discriminant analysis was adopted to construct the discriminant equation based on APOM concentration for evaluating its discriminant significance to the disease severity.Results The serum APOM concentration in the bacterial pneumonia group was（28.9±10.5）μg/mL,which was significantly higher than（19.4±8.93）μg/mL in viral pneumonia group,（16.4±5.62）μg/mL in the other pneumonia group and（18.1±6.15）μg/mL in the healthy controls,the differences had statistical significance（P〈0.01）.The area under ROC curve for APOM in diagnosing bacterial pneumonia could reach 0.843,showing the good sensitivity and specificity.Moreover,the serum APOM concentration was positively correlated with the disease severity of bacterial pneumonia.The discriminant equation based on APOM concentration as well as sex,age,systolic pressure,body temperature and heart rate could better conduct the classification on the disease severity of bacterial pneumonia and its accuracy could reach to 86.7%.Conclusion The serum APOM concentration has an important clinical value for the diagnosis of bacterial pneumonia and its disease severity evaluation.