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

江波; 时鹏; 刘东亮; 桑庆庆; 宋传旺; 桑道乾

doi:10.16766/j.cnki.issn.1674-4152.001861

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

doi: 10.16766/j.cnki.issn.1674-4152.001861

1.
蚌埠医学院第一附属医院神经内科，安徽蚌埠 233004
2.
蚌埠医学院免疫教研室，安徽蚌埠 233030

基金项目:

安徽省自然科学基金面上项目 1708085MH218

详细信息

通讯作者:
桑道乾, E-mail: sangdq@sina.com

中图分类号: R741.04
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- 文章访问数: 229
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- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2020-07-17
- 网络出版日期: 2022-02-16

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

1.
Department of Neurology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 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-Barré syndrome，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。
- 白蛋白 /
- 球蛋白 /
- 肌酐 /
- 吉兰-巴雷综合征
Abstract: Objective To explore the application of serum albumin, globulin and creatinine to predict the severity of Guillain-Barré syndrome (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.
- Albumin /
- Globulin /
- Creatinine /
- Guillain-Barré syndrome

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图 1 预测GBS重症组的ROC曲线分析

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表 1 GBS患者和健康对照组基线资料比较(x ±s)

组别	例数	年龄(岁)	性别(男/女，例)	白蛋白(g/L)	球蛋白(g/L)	肌酐(μmol/L)	尿素氮[M(P₂₅，P₇₅)，mmol/L]	总胆红素(μmol/L)	ALT(U/L)	AST [M(P₂₅，P₇₅)，U/L]
GBS组	106	53.84±19.39	72/34	40.12±4.43	29.94±5.68	63.47±11.64	5.32(4.30，6.80)	12.78±5.44	35.80±39.51	24.00(20.00, 34.00)
对照组	150	53.59±19.29	97/53	47.42±4.14	24.58±6.17	83.96±31.00	5.33(4.27，6.65)	12.47±3.30	33.67±14.62	31.70(17.09, 40.69)
统计量		-0.171^a	2.000^b	13.501^a	7.080^a	-6.490^a	-0.624^c	-0.563^a	-0.606^a	-1.119^c
P值		0.872	0.157	< 0.001	< 0.001	< 0.001	0.533	0.574	0.545	0.263
注：^a为t值，^b为χ²值，^c为Z值。

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表 2 GBS患者实验室指标与疾病严重程度的相关性分析

项目	r值	P值
白蛋白	-0.178	0.068
球蛋白	0.353	< 0.001
肌酐	-0.323	0.001
尿素氮	0.016	0.874
总胆红素	0.029	0.771
ALT	0.028	0.773
AST	-0.012	0.904

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表 3 GBS患者Hughes功能评分与临床特征间的多元线性回归分析结果

变量	B	SE	β	t值	P值
常量	3.893	2.047		1.902	0.600
性别	0.001	0.288	<0.001	0.002	0.998
年龄	0.003	0.007	0.038	0.372	0.711
白蛋白	-0.027	0.032	-0.088	-0.839	0.403
球蛋白	0.075	0.023	0.315	3.313	0.001
肌酐	-0.035	0.011	-0.300	-3.099	0.003
尿素氮	-0.033	0.024	-0.122	-1.342	0.183
总胆红素	0.018	0.024	0.072	0.739	0.462
ALT	-0.007	0.006	-0.208	-1.289	0.201
AST	0.009	0.008	0.185	1.137	0.258
注：性别按照男为0，女为1赋值，其他以实际数据赋值，因变量以Hughes评分赋值。

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