临床实验室常见指标在重症肌无力诊断中的应用价值

Application value of common clinical laboratory indicators in the diagnosis of myasthenia gravis

目的分析重症肌无力(MG)患者基础病例资料及实验室检测指标特点,评估临床实验室常见指标在MG诊断中的应用价值。方法回顾性分析2021年4月至2023年4月在首都医科大学附属北京天坛医院确诊为MG的84例患者和性别、年龄匹配的103例健康体检者的基础资料及实验室指标。构建诊断模型,绘制受试者工作特征(ROC)曲线并分析曲线下面积。结果MG组体重指数(BMI)、心率、收缩压和舒张压显著高于对照组,差异均有统计学意义(P<0.05);MG组与对照组总蛋白、白蛋白、白细胞计数、大血小板比例、单核细胞群绝对值、三碘甲状腺原氨酸等比较,差异有统计学意义(P<0.05)。选择心率、舒张压、白蛋白、肌酸激酶、胆碱酯酶、甘油三酯、载脂蛋白B 7项指标构建诊断模型,多指标联合应用诊断MG的曲线下面积可达0.995,灵敏度和特异度分别为97.60%和96.10%。结论成功筛选出了可用于MG诊断的实验室检测指标,多指标联合应用的灵敏度和特异度均较高,可以用于MG的辅助诊断。

Objective To analyze the basic case data and laboratory test index characteristics of patients with myasthenia gravis(MG),so as to evaluate the application value of common clinical laboratory indicators in the construction of a diagnostic model for MG.Methods A retrospective analysis was performed on the basic data and laboratory indicators of MG patients and gender and age-matched healthy controls diagnosed at Beijing Tiantan Hospital,Capital Medical University from April 2021 to April 2023.A diagnostic model was constructed,and the receiver operating characteristic(ROC)curve was drawn to analyze the area under the curve(AUC).Results The BMI,heart rate,systolic blood pressure,and diastolic blood pressure in the MG group were significantly higher than those in the control group,with statistical significance(P<0.05).There were significant differences in total protein,albumin,white blood cell count,proportion of large platelets,absolute value of monocyte and triiodothyronine between MG group and control group(P<0.05).Seven indexes of heart rate,diastolic blood pressure,albumin,creatine kinase,cholinesterase,triglyceride and apolipoprotein B were selected to construct the diagnostic model.The area under the curve of the combined application of multiple indexes could reach 0.995,with a sensitivity and specificity of 97.60%and 96.10%,respectively.Conclusion In this study,the laboratory test indexes that can be used for the diagnosis of MG are successfully selected,and the sensitivity and specificity of the combined application of multiple indexes are high,which can be used for the auxiliary diagnosis of MG.