威尔逊病诊断中的相对可交换铜,可交换铜和总铜
Camilla Lorenzen1, Karen Dons1, Clàudia García-Solà2
1Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
概括
相对可交换铜 (REC) 对威尔逊病 (WD) 的诊断价值很高. 总铜 (Total Cu) 也表现出强的性能,建议将其纳入WD诊断评分.
科学领域:
- 生物化学 生化学
- 医学诊断 医学诊断 医学诊断
- 肝病学 肝病学是一种肝病学.
背景情况:
- 诊断威尔逊病 (WD) 存在重大挑战.
- 可交换的铜 (CuEXC) 测量的是非烯胺结合的铜.
- 相对可交换铜 (REC) 是WD的一个拟议生物标志物.
研究的目的:
- 为了评估CuEXC的诊断性能,总血清铜 (总Cu) 和威尔逊病中的REC.
- 为了在不同患者群体中比较这些生物标志物.
主要方法:
- 测量了CuEXC和总Cu水平的患者WD (治疗-naive和治疗),非威尔逊肝病和急性肝衰竭.
- REC被计算为CuEXC与总Cu的比率.
- 进行了接收器操作特征 (ROC) 分析以评估诊断准确性.
主要成果:
- 与所有其他组相比,WD患者的REC中位数显著增加 (23.6%与4.9%,p < 0.001).
- 在WD患者中,总Cu显著降低 (3.5μmol/L与17.2μmol/L相比,p < 0.001).
- 最佳REC切断值 (≥13.8%) 实现了100%的灵敏度和99.6%的特异性,用于新诊断的WD与非威尔逊肝病.
结论:
- 相对可交换铜 (REC) 对威尔逊病具有显著的诊断价值.
- 总铜 (Total Cu) 也显示出强大的诊断性能和初始处理中的实用性.
- 应考虑将REC和/或Total Cu纳入未来对莱比锡分数进行WD诊断的修订.
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