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血清犬弓蛔虫特异性免疫球蛋白G抗体对眼弓蛔虫病的诊断价值

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目的 评价血清犬弓蛔虫特异性免疫球蛋白G抗体(anti-T-IgG)在眼弓蛔虫病(OT)中的诊断价值。方法 诊断试验。2015年6月至2022年12月于徐州市第一人民医院眼科就诊的疑似OT患者109例109只眼纳入研究。根据临床表现及Goldmann-Witmer系数将患者分为OT组、非OT组,分别为76例76只眼、33例33只眼。配对收集患者血清和眼内液样本,行酶联免疫吸附测定,检测血清及眼内液中anti-T-IgG水平。组间比较采用Mann-Whitney检验。采用受试者工作特征曲线(ROC)下面积评价血清anti-T-IgG对OT的诊断价值。采用Kappa检验分析血清、眼内液anti-T-IgG阳性率与OT诊断的一致性。采用Spearman秩相关进行相关性分析。结果 与非OT组比较,OT组中儿童及有猫狗接触史(x2=9。785、12。026)患者明显增高,差异有统计学意义(P<0。01);患者血清anti-T-IgG阳性率(x2=24。551)及U值水平(Z=-4。379)明显升高,差异均有统计学意义(P<0。000 1)。以试剂盒推荐的11 U为临界值,血清anti-T-IgG诊断OT的灵敏度、特异性分别为0。72、0。79,阳性、阴性预测值分别为0。89、0。55,ROC下面积为0。77,95%可信区间(CI)0。669~0。860。相关性分析结果显示,血清与眼内液anti-T-IgG水平呈正相关(rs=0。520,95%CI 0。363~0。648,P<0。000 1)。血清、眼内液anti-T-IgG阳性率与OT诊断一致性的Kappa值分别为0。457(95%CI0。292~0。622)、0。711(95%CI0。582~0。840);血清anti-T-IgG阳性率与OT诊断Kappa值低于眼内液。结论 血清anti-T-IgG的灵敏度、特异性以及血清anti-T-IgG阳性率与OT诊断的一致性均较低,血清anti-T-IgG水平不能作为OT诊断依据。
The diagnostic value of serum anti-toxocara immunoglobulin G in ocular toxocariasis patients
Objective To assess the diagnostic performance of serum anti-toxocara immunoglobulin G(anti-T-IgG)in ocular toxocariasis(OT)patients.Methods A diagnostic tests.A total of 109 patients(109 eyes)with clinically-suspected OT who treated in Department of Ophthalmology of Xuzhou First People's Hospital from June 2015 to December 2022 were included.Patients were divided into two groups,76 with OT and 33 with non-OT,according to the clinical manifestations and Goldmann-Witmer coefficient.Paired serum and intraocular fluid samples from each patient were collected and analyzed for specific anti-T-IgG using enzyme linked immunosorbent assay.Mann-Whitney test was performed for comparison between groups.The area under the receiver operating characteristic curve(ROC)was used to assess the diagnostic performance of serum anti-T-IgG.Kappa analysis was performed to examine the consistency of serum or intraocular fluid anti-T-IgG positive rate with OT diagnostic result.Spearman's rank correlation test was performed to assess the association.Results Compared with the non-OT group,the proportions of children and history of exposure to cats and dogs(x2=9.785,12.026)were significantly higher in OT group,and the differences were statistically significant(P<0.01).The positive rate(x2=24.551)and U value(Z=-4.379)of serum anti-T-IgG in OT group were higher than those in non-OT group,and the differences were statistically significant(P<0.000 1).The recommended serum anti-T-IgG cut-off value of 11 U had 0.72 sensitivity,0.79 specificity,0.89 positive predictive value,0.55 negative predictive value,and 0.77 area under the ROC with 95%confidence interval(CI)0.669-0.860.Correlation analysis showed that serum anti-T-IgG was positively correlated with intraocular fluid anti-T-IgG(r,=0.520,95%CI 0.363-0.648,P<0.000 1).The Kappa values of serum and intraocular fluid anti-T-IgG positive rate with OT diagnosis were 0.457(95%CI 0.292-0.622)and 0.711(95%CI 0.582-0.840),respectively.The Kappa value of serum anti-T-IgG positive rate with OT diagnosis was lower than that of intraocular fluid.Conclusion The sensitivity and specificity of serum anti-T-IgG and the consistency between serum anti-T-IgG positive rate and OT diagnosis are low,suggesting that serum anti-T-IgG level cannot be used as a basis for OT diagnosis.

Ocular ToxocariasisAnti-toxocara immunoglobulin GSerumDiagnostic value

徐青、宫朝举、杨潇、刘亚鲁、李婕、盛爱芹、张翼鹏、乔磊、黎严莲、李甦雁

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徐州医科大学附属徐州市立医院眼科徐州市第一人民医院徐州市眼病防治研究所,徐州 221116

眼弓蛔虫病 犬弓蛔虫特异性免疫球蛋白G抗体 血清 诊断价值

徐州市重点研发计划徐州市卫生健康委科技项目徐州市科技计划基础研究面上项目

KC22227XWKYHT20220098KC22066

2024

中华眼底病杂志
中华医学会

中华眼底病杂志

CSTPCD北大核心
影响因子:0.928
ISSN:1005-1015
年,卷(期):2024.40(5)
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