联合检测HLA-G、IL-6在传染性单核细胞增多症患儿中的诊断价值

Diagnostic Value of Combined Detection of HLA-G and IL-6 in Children with Infectious Mononucleosis

目的:探讨联合检测血浆白细胞抗原G(HLA-G)、白介素-6(IL-6)在传染性单核细胞增多症(infectious mononucleosis,IM)患儿中的诊断价值。方法:选取2014年1月至2017年6月于华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)住院诊断治疗的传染性单核细胞增多症患儿83例为IM组,选择同期健康儿童83例为对照组。采用酶联免疫吸附法检测并比较2组儿童HLA-G、IL-6水平变化;计算并对比血浆HLA-G、IL-6阳性率;分析IM组血浆HLA-G与IL-6相关性;绘制ROC曲线并对比血浆HLA-G、IL-6及二者联合检测的诊断效能。结果:IM组血浆HLA-G和IL-6水平显著高于对照组(P<0.01)。未经治疗的IM患儿中血浆HLA-G检测阳性率为90.36%(75/83),IL-6检测阳性率为87.95%(73/83),二者比较差异无统计学意义(P>0.05)。IM组血浆HLA-G与IL-6水平呈正相关(r=0.196,P=0.011)。ROC曲线诊断效能分析结果显示,IL-6诊断的灵敏度为68.90%,特异度为71.50%,ROC曲线下面积为0.703。血浆HLA-G诊断的灵敏度为74.20%,特异度为77.50%,ROC曲线下面积为0.761。二者联合诊断的灵敏度为89.50%,特异度为85.70%,ROC曲线下面积为0.906。结论:血浆HLA-G与IL-6联合检测在传染性单核细胞增多症具有较高的灵敏度和准确度,对明确患儿病情进展发挥积极作用,值得临床推广应用。

Objective： To investigate the diagnostic value of combined detection of HLA-G and IL-6 in children with infectious mononucleosis（ IM）. Methods： Eighty-three children suffered from infectious mononucleosis hospitalized in Wuhan Children＇s Hospital（ Wuhan Maternal and Child Healthcare Hospital） from January 2014 to June 2017 were selected as the IM group,83 healthy children in the same period were selected as the as control group. Enzyme-linked in munosorbent assay（ ELISA） was used to detect and compare the changes of HLA-G and IL-6 levels between 2 groups. The positive rate of HLA-G and IL-6 were calculated and compared. The correlation of plasma HLA-G with IL-6 in IM group was analyzed,the MOC curve was drawn,and the diagnostic efficiencies of plasma HLA-G and IL-60 alone as well as 2 combined detection were compared. Results： The plasma level of HLA-G and IL-6 in IM group was significantly higher than that in control group,and the difference between the 2 groups was were statistically significant（ P〈0. 01）. In untreated children with infectious mononucleosis,the positive rate of plasma HLA-G detection was90. 36%（ 75/83） and the positive rate of IL-6 detection was 87. 95%（ 73/83） without a significant difference between2 groups（ P〈0. 05）. There was a positive correlation between the plasma HLA-G and IL-6 levels in the observation group（ r = 0. 196,P〈0. 05）. The analysis of ROC curve diagnostic effectiveness showed that the diagnostic sensitivity of IL-6 was 68. 90%,the specificity was 71. 50%,and the area under the ROC curve was 0. 703. The diagnostic sensitivity of the plasma HLA-G was 74. 20%,the specificity was 77. 50%,and the area under the ROC curve was 0. 761. The combined diagnostic sensitivity and specificity of 2 methods was 89. 50% and 85. 70% respectively,and the area under the ROC curve was 0. 906. Conclusion： The combination of HLA-G and IL-6 for detect infectious mononucleosis resulted in a high sensitivity and accuracy,which is helpful to define the progress of the patient＇ s condition,and worth for clinical application.