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[目的]构建受试者工作特征(ROC)曲线模型,应用ROC曲线探讨血清巨噬细胞炎症蛋白-1α(MIP-1α)在煤工尘肺病早期诊断中的价值。[方法]选择某煤业集团公司经职业健康检查的、肺部有小阴影但不够诊断为尘肺一期的180名接尘工人作为观察组,180名肺部完全正常的接尘工人作为接尘组,109名煤工尘肺一期患者作为病例组,采集空腹静脉血,使用酶联免疫吸附法测定3组研究对象血清中趋化因子MIP-1α的表达水平,采用ROC曲线对MIP-1α筛检煤工尘肺的作用进行评价。[结果]经协方差分析,控制年龄因素的影响后,病例组MIP-1α的表达水平均高于接尘组和观察组,差异均有统计学意义(P<0.05),观察组MIP-1α的表达水平高于接尘组,差异有统计学意义(P<0.05)。对接尘工龄分层后进行分析,结果表明病例组在10~年、20~年和30~38年3个工龄段MIP-1α表达水平均高于观察组和接尘组,差异均有统计学意义(P<0.05),观察组在10~年、20~年和30~38年3个工龄段MIP-1α表达水平均高于接尘组,差异均有统计学意义(P<0.05);病例组、观察组和接尘组MIP-1α表达水平随着工龄的增加有增高趋势。构建ROC曲线,曲线下面积为0.874,最佳界值为940.85 ng/L,灵敏度为75.2%,特异度为90.0%,漏诊率为24.8%、误诊率为10%、约登指数为65.2%、阳性似然比为7.52、阴性似然比为0.28、符合率为0.87、Kappa值为0.63、阳性预测值为69.49%、阴性预测值为92.31%,收益是36人。[结论]经ROC曲线评价,MIP-1α作为筛检指标具有较高的真实性和可靠性,在煤工尘肺早期诊断中具有较高的参考价值。
[Objective] To construct ROC curve model and investigate the value of serum macrophage inflammatory protein-1α (MIP-1α) in the early diagnosis of coal worker’s pneumoconiosis by ROC curve. [Methods] A total of 180 dust-exposed workers with a small shadow in the lungs but not enough to be diagnosed as pneumoconiosis were selected as the observation group and 180 dust-exposed workers with completely normal lungs as the dust pick-up Group, 109 coal workers with pneumoconiosis as a case group, fasting venous blood was collected, the serum levels of chemokines MIP-1α were measured by enzyme-linked immunosorbent assay, the ROC curve MIP-1α sieve The role of coal workers pneumoconiosis evaluation. [Results] The results of covariance analysis showed that the expression level of MIP-1α in case group was higher than that in control group and dust control group (P <0.05). The MIP-1α The level of expression was higher than the dust exposure group, the difference was statistically significant (P <0.05). The results showed that the expression levels of MIP-1α in three working age groups of 10 ~ year, 20 ~ 30 years and 30 ~ 38 years were higher than that of the observation group and the dust exposure group, the differences were statistically significant (P <0.05). The expression level of MIP-1α in observation group was higher than that in control group at 10 years, 20 years and 30-38 years (P <0.05). The expression level of MIP-1α in case group, observation group and dust exposure group increased with the increase of service life. The area under the curve was 0.874, the best cutoff was 940.85 ng / L, sensitivity was 75.2%, specificity was 90.0%, misdiagnosis rate was 24.8%, misdiagnosis rate was 10%, Youden index was 65.2% The positive likelihood ratio was 7.52, the negative likelihood ratio was 0.28, the coincidence rate was 0.87, the Kappa value was 0.63, the positive predictive value was 69.49%, the negative predictive value was 92.31%, and the income was 36. [Conclusion] The MOC-1α as a screening index has high authenticity and reliability through ROC curve evaluation and has high reference value in the early diagnosis of pneumoconiosis in coal workers.