传统检测汗液氯离子方法对中国囊性纤维化患者的诊断价值

Diagnostic value of traditional sweat chloride test for Chinese cystic fibrosis patients

目的探讨传统检测汗液氯离子方法的准确性及对中国囊性纤维化(CF)患者的诊断价值。方法用传统检测汗液氯离子方法测定了2012年1月至2019年10月北京协和医院收治的118例疑似CF患者的汗液氯离子浓度,并与患者的最终诊断比较并分析。结果筛查患者数118例,平均年龄(25.8±13.6)岁。其中102例获得有效汗液氯离子检测数据,其浓度中位数为43.3 mmol/L(IQR:23.8~120.1 mmol/L)。80例患者的汗液氯离子检测结果符合诊断;39例汗液氯离子检测为阳性结果(≥60 mmol/L),其中31例(79.49%)确诊CF;40例阴性结果(<30 mmol/L),其中32例(80%)排除CF;23例处于临界值(30~59 mmol/L),其中17例(73.91%)排除CF,其余6例(26.09%)未能明确诊断;66例(64.71%)具有可重复性。结论汗液氯离子测定结果的CF阳性预测值为79.49%,阴性预测值为80%。传统汗液氯离子检测方法对于中国CF患者具有较高诊断价值。

Objective To explore the accuracy of traditional sweat chloride test and its diagnostic value for Chinese patients with cystic fibrosis(CF).Methods The sweat chloride level in 118 patients who were suspected to have CF in Peking Union Medical College Hospital from Jan 2012 to Oct 2019 was measured,and the results were compared with the confirmed diagnosis.Results The patients'ages were(25.8±13.6)years old(15 months-67 years old).One hundred and two out of 118 patients obtained valid chloride level from their sweat chloride tests with median concentration of 43.3 mmol/L(IQR:23.8-120.1 mmol/L).Eighty were consistent with their diagnosis.Thirty-nine patients had sweat chloride values higher than 60 mmol/L,while 31(79.49%)of them were finally confirmed CF diagnosis.Sweat chloride levels of fourty cases were lower than 30 mmol/L,of which 32(80%)cases were excluded from CF.Twenty-three patients had sweat chloride level between 30 and 59 mmol/L,while 17(73.91%)of them were excluded from CF diagnosis.66(64.71%)of our patients had reproducible results of the sweat chloride level.Conclusions The positive predictive value of the sweat chloride test is 79.49%and the negative predictive value is 80%using traditional sweat chloride test measurement.The traditional sweat chloride test has high diagnostic value for Chinese CF patients.