| 谢京志,罗飞,宗娟,等.α1-酸性糖蛋白在成人斯蒂尔病与败血症鉴别中的诊断价值[J].安徽医药,2025,29(7):1442-1446. |
| α1-酸性糖蛋白在成人斯蒂尔病与败血症鉴别中的诊断价值 |
| Diagnostic value of α1-acid glycoprotein in differentiating adult-onset Still's disease (AOSD) from sepsis |
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| DOI：10.3969/j.issn.1009-6469.2025.07.036 |
| 中文关键词: α1-酸性糖蛋白 斯蒂尔病 败血症 鉴别诊断 成年人 |
| 英文关键词: α1-acid glycoprotein Still disease Sepsis Differential diagnosis Adult |
| 基金项目: |
| 作者 | 单位 | E-mail | | 谢京志 | 徐州医科大学研究生院,江苏徐,州221002 | | | 罗飞 | 徐州医科大学研究生院,江苏徐,州221002 | | | 宗娟 | 徐州医科大学研究生院,江苏徐,州221002 | | | 方权权 | 徐州医科大学研究生院,江苏徐,州221002 | | | 殷松楼 | 徐州医科大学附属医院风湿免疫科,江苏徐州 221002 | | | 周冬梅 | 徐州医科大学附属医院风湿免疫科,江苏徐州 221002 | zdm@xzhmu.edu.cn |
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| 中文摘要: |
| 目的探讨 α1-酸性糖蛋白在成人斯蒂尔病( adult-onset Still's disease，AOSD)和败血症鉴别中的诊断价值。方法选取收集徐州医科大学附属医院 2018年 12月至 2022年 3月收治的 47例首次确诊为成人斯蒂尔病( AOSD)和 60例确诊为败血症的病人，收集两组病人的血液学指标，比较两组病人各血液学指标的差异性。采用二元 logistic回归分析 AOSD的独立危险因素；采用受试者操作特征曲线( ROC曲线)评价 α1-酸性糖蛋白、铁蛋白、白细胞计数以及联合检测对 AOSD病人的风险预测价值。另收集 2022年 4月至 2023年 3月该院收治的首次确诊为成人斯蒂尔病( AOSD)的 13例病人和确诊为败血症的 20例病人作为外部验证。结果 AOSD组 α1-酸性糖蛋白水平明显高于败血症组［(11.88±2.29)mmol/L比( 8.90±2.41)mmol/L，P<0.05］，多因素 logistic回归分析显示 α1-酸性糖蛋白 ≥10.42 mmol/L(P<0.05)、铁蛋白 ≥1 176.00 μg/L(P<0.05)、白细胞计数 ≥11.45×109/L(P<0.05)是 AOSD发生的独立危险因素。 α1-酸性糖蛋白鉴别诊断 AOSD与败血症的曲线下面积( AUC)为 0.82，当截断值为 10.42 mmol/L时，诊断灵敏度为 0.83，特异度为 0.70，外部验证示 α1-酸性糖蛋白的鉴别诊断 AUC为 0.72。结论 α1-酸性糖蛋白可作为 AOSD和败血症的鉴别诊断指标，对 AOSD的诊断具有临床价值。 |
| 英文摘要: |
| Objective To explore the diagnostic value of α1-acid glycoprotein in differentiating adult-onset Still's disease (AOSD) from sepsis.Methods Forty-seven patients diagnosed with adult Still's disease (AOSD) and 60 patients diagnosed with sepsis in theAffiliated Hospital of Xuzhou Medical University from December 2018 to March 2022 were selected and collected. The hematologicalindexes of the two groups were collected, and the differences of hematological indexes between the two groups were compared. Binarylogistic regression analysis was conducted to identify the independent risk factors for AOSD and ROC curve analysis to evaluate the pre-dictive values of α1-acid glycoprotein, ferritin, white blood cell count, and the combined detection of the three for the risk of AOSD. Ad-ditionally, 13 patients with AOSD and 20 patients with sepsis admitted to the hospital from April 2022 to March 2023 were collected asexternal validation.Results The level of α1-acid glycoprotein in the AOSD group was significantly higher than that in the sepsis group [(11.88±2.29) mmol/L vs. (8.90±2.41) mmol/L, P <0.05]. Multivariate logistic regression analysis results showed that α1-acid glycopro-tein ≥10.42 mmol/L, ferritin ≥1 176.00 μg/L, and white blood cell count ≥11.45×109/L were independent risk factors for AOSD (all P< 0.05). The area under the curve (AUC) of α1-acid glycoprotein for the differential diagnosis of AOSD and sepsis was 0.82. When the cut-off value was 10.42 mmol/L, the diagnostic sensitivity was 0.83, and specificity was 0.70. External verification showed that the AUCof α1-acid glycoprotein was 0.72.Conclusion α1-acid glycoprotein can be used as a diagnostic indicator for differentiating AOSDfrom sepsis in adults, which has clinical value in the diagnosis of AOSD. |
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