血清白蛋白和球蛋白及肌酐评估吉兰-巴雷综合征严重程度的价值

Application of serum albumin,globulin and creatinine in predicting the severity of Guillain-Barrésyndrome

目的探讨应用血清白蛋白、球蛋白及肌酐水平预测吉兰-巴雷综合征(Guillain-Barrésyndrome, GBS)的严重程度。方法选取2016年6月—2020年5月蚌埠医学院第一附属医院神经内科收治的吉兰-巴雷综合征患者106例,采用Hughes功能评分,同时选取健康受试者150名,比较2组间白蛋白、球蛋白、肌酐的差异。采用Spearman相关性分析对白蛋白、球蛋白及肌酐水平与GBS患者疾病严重程度的相关性进行分析。选取与疾病严重程度相关的球蛋白与肌酐,并利用ROC曲线进行分析。结果 GBS患者血清白蛋白(40.12±4.43)g/L和肌酐(63.47±11.64)μmol/L水平低于健康对照组[(47.42±4.14)g/L;(83.96±31.00)μmol/L,均P<0.05];而球蛋白(29.94±5.68)g/L水平高于健康对照组[(24.58±6.17)g/L,P<0.05];GBS患者球蛋白和肌酐水平与疾病严重程度有一定相关性(r=0.353,P<0.001;r=-0.323,P=0.001)。受试者工作曲线(ROC)显示球蛋白预测GBS重症组的曲线下面积为0.699(95%CI:0.602~0.784)。肌酐预测GBS重症组的曲线下面积为0.671(95%CI:0.573~0.760)。结论 GBS患者球蛋白水平与疾病严重程度呈正相关,肌酐水平与疾病严重程度呈负相关。球蛋白和肌酐对评估GBS严重程度有一定的价值。

Objective To explore the application of serum albumin,globulin and creatinine to predict the severity of Guillain-Barrésyndrome(GBS).Methods A total of 106 patients with GBS treated in the Department of Neurology,the first affiliated Hospital of Bengbu Medical College from June 2016 to May 2020 were selected.Hughes functional score was used to compare the differences of albumin,globulin and creatinine between the two groups.Spearman correlation analysis was used to analyze the correlation between the levels of albumin,globulin,creatinine and the severity of disease in patients with GBS.The globulin and creatinine related to the severity of the disease were selected and analyzed by ROC curve.Results The levels of serum albumin(40.12±4.43)g/L and creatinine(63.47±11.64)μmol/L in GBS patients were lower than those in healthy controls[(47.42±4.14)g/L,(83.96±31.00)μmol/L,all P<0.05],while the levels of globulin(29.94±5.68)g/L were higher than those in healthy controls(24.58±6.17)g/L,P<0.05.The levels of globulin and creatinine in patients with GBS were correlated with the severity of the disease(r=0.353,P<0.001;r=0.323,P<0.001).The ROC curve showed that the area under the curve of globulin predicting GBS severe group was 0.699(95%CI:0.602-0.784).The area under the curve predicted by creatinine in GBS severe group was 0.671(95%CI:0.573-0.760).Conclusion The level of globulin in patients with GBS is positively correlated with the severity of the disease,while the level of creatinine is negatively correlated with the severity of the disease.Globulin and creatinine have certain value in evaluating the severity of GBS.