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目的探讨血清中内毒素、CD14、IFN-γ水平检测诊断小儿先天性胆道闭锁(BA)的价值。方法选取该院诊断为小儿先天性BA的患儿24例为研究组,另选取在我院体检身体正常的健康小儿10例为对照组,基于酶联免疫吸附试验(ELISA)试剂盒法对2组血清中Ohkuma’s分级的各级内毒素、CD14、IFN-γ水平进行检测,并分析各指标单独或联合用于诊断小儿BA的敏感性、特异性和准确度。结果 2组各分级间内毒素水平差异无统计学意义(P>0.05)。CD14水平由对照组到研究组各级呈依次递减,各级间差异有统计学意义(P<0.05)。IFN-γ水平研究组各级间呈现依次递增,且差异有统计学意义(P<0.05)。内毒素的敏感性、特异性和准确度最差,CD14与IFN-γ能力相当,而内毒素、CD14、IFN-γ三者联合的敏感性、特异性和准确度最强。结论内毒素与小儿BA患病相关不明显,用于BA诊断评定准确度较差,而CD14、IFN-γ水平均与小儿BA发病相关明显,且联合比单独用于BA诊断评定的特异性、灵敏性及准确度高。
Objective To investigate the value of serum endotoxin, CD14 and IFN-γ in the diagnosis of children with congenital biliary atresia (BA). Methods Twenty-four children diagnosed as congenital BA in our hospital were selected as the study group. Ten healthy healthy children in our hospital were selected as the control group. Based on the ELISA kit, The levels of endotoxin, CD14 and IFN-γ at different levels of Ohkuma’s were detected in serum of each group, and the sensitivity, specificity and accuracy of each index alone or in combination to diagnose pediatric BA were analyzed. Results There was no significant difference in endotoxin levels between the two groups (P> 0.05). The levels of CD14 decreased gradually from the control group to the study group, with significant differences at all levels (P <0.05). The levels of IFN-γ in all the groups showed an order of increasing, with significant difference (P <0.05). Endotoxin has the poorest sensitivity, specificity and accuracy. CD14 and IFN-γ have the same capacity. The combination of endotoxin, CD14 and IFN-γ has the strongest sensitivity, specificity and accuracy. Conclusions The endotoxin is not significantly correlated with the prevalence of BA in children and is less accurate in the diagnostic evaluation of BA. The levels of CD14 and IFN-γ are significantly correlated with the incidence of BA in children, and the specificity of combination is higher than that of BA alone. High sensitivity and accuracy.