外周血Cryab联合MRI检测对视神经脊髓炎的诊断价值

Expression of peripheral Cryab combined with MRI in diagnosis of neuromyelitis optica

目的评价外周血αβ-晶状体蛋白(Cryab)联合MRI检测对视神经脊髓炎(NMO)的诊断价值。方法选取2019年1月至2020年2月长兴县人民医院收治的NMO患者53例作为NMO组,同期在本院门诊进行健康体检的健康志愿者50例作为对照组。采用Western blot法检测所有研究对象外周血Cryab表达水平,收集所有研究对象颅脑MRI图像,比较两组研究对象外周血Cryab表达水平及颅脑影像状况。分析外周血Cryab、颅脑MRI及两者联合检测诊断NMO的灵敏度与特异度,及外周血Cryab联合MRI检测与临床确诊结果的一致性。结果NMO组患者外周血Cryab表达水平为0.825±0.251,高于对照组的0.305±0.077,差异有统计学意义(P<0.05)。外周血Cryab对NMO诊断的灵敏度和特异度分别为0.774、0.860;MRI检测对NMO诊断的灵敏度和特异度分别为0.679、1.000;外周血Cryab联合MRI检测对NMO诊断的灵敏度和特异度分别为0.755、1.000。相比于单独检测,两者联合检测的灵敏度与特异度均得到较大提高,且与临床确诊结果的一致性良好(Kappa=0.749)。结论外周血Cryab联合MRI检测可以较准确地诊断NMO,能够为患者的临床诊治提供指导信息。

Objective To evaluate the diagnostic value of peripheral blood crystallin-αβ(Cryab)combined with MRI for patients with neuromyelitis optica(NMO).Methods Fifty-three NMO patients admitted to Changxing County People's Hospital from January 2019 to February 2020 were enrolled(NMO group),and 50 healthy subjects were recruited as the control group.The brain MRI scan was performed,and the expression of Cryab protein in peripheral blood was detected with Western blot in all subjects.The diagnostic sensitivity and specificity of Cryab expression,MRI and their combination were analyzed,and the consistency of Cryab and MRI in diagnosis of NMO was also analyzed.Results The expression level of Cryab protein in peripheral blood of NMO group was 0.825±0.251,which was significantly higher than that of control group(0.305±0.077)(P<0.05).The sensitivity and specificity of peripheral blood cryab for diagnosis of NMO were 0.774 and 0.860,respectively,the sensitivity and specificity of MRI in the diagnosis of NMO were 0.679 and 1.000,those of the combination of cryab expression and MRI were 0.755 and 1.000,respectively.The consistency of cryab and MRI in diagnosis of NMO was at a good level(Kappa=0.749).Conclusion The combination of peripheral blood Cryab expression and MRI scan can improve the diagnostic accuracy for NMO patients.