ROC曲线在评价髓鞘碱性蛋白早期诊断Guillain-Barré综合征中的应用

目的运用受试者工作特征（ROC）曲线评价脑脊液（CSF）及血清（Serum）中髓鞘碱性蛋白（MBP）早期诊断Guillain-Barre综合征（GBS）的价值。方法用ELISA法检测GBS组（36例）中MBP的水平并和对照组（33例）相比较。运用ROC曲线评价CSF及Serum中MBP诊断GBS的敏感性及特异性。结果GBS组CSF中MBP的水平明显高于对照组（P〈0．01），Serum中MBP水平和对照组相比差异无统计学意义。CSFMBP诊断GBS的ROC曲线下面积（AUC）为0．804±0．056，最佳分界值为0．65pg／mL。以CSFMBP≥0．65pg／mL来预测GBS，敏感性为80．6％，特异性为78．8％。Serum MBP ROC曲线的AUC为0．548±0．070，最佳分界值为0．20pg／mL。以Serum MBP≥0．20pg／mL来预测GBS，敏感性为44．4％，特异性为69．7％。两条曲线AUC的差异有统计学意义（P〈0．01）。结论CSFMBP水平对诊断早期GBS有一定的准确性，可以作为早期诊断GBS较为敏感的指标。

Application of Receiver Operating Characteristic Curves in Evaluating the Use of Myelin Basic Protein for the Diagnosis of Initial Guillain-Barre Syndrome

Objective To evaluate the application of myelin basic protein （MBP） in cerebral spinal fluid （CSF） and serum for the diagnosis of initial Guillain-Barre syndrome （GBS） by receiver operating characteristic （ROC） curves. Methods The levels of MBP were measured in the CSF and serum of patients with GBS （36 cases） by ELISA method and compared with those of controls （33 cases）. The ROC curves were used to evaluate the sensitivity and specificity of MBP in CSF and serum in the diagnosis of GBS. Results Level of MBP in CSF increased significantly in GBS patients compared with that in control subjects （P〈0.01）, but the level of MBP in serum was not statistically different from that in control subjects. The area under cure （AUC） of the ROC cure of CSF MBP to diagnose GBS was 0.804±0.056, the optimal cut-off point was 0.65 pg/mL. MBP in CSF, ≥0.65 pg/mL, could be used to predict the presence of GBS with a sensitivity of 80.6% and specificity of 78.8%. The AUC of the ROC cure of serum MBP was 0.548± 0.070, and the optimal cut-off point was 0.20 pg/mL. MBP in CFS, ≥0.20 pg/mL, could be used to predict the presence of GBS with a sensitivity of 44.4% and specificity of 69.7%. There was statistically significant difference between the AUC of the two curves （P〈0.01）. Conclusion The level of MBP in CSF is a sensitive and accurate marker for the diagnosis of initial GBS.