Lu Yi, Liu Xiao-Qing, Wang Xiao-Hong, Wang Jian-She
Childrens Hospital of Fudan University, Shanghai 201102, China.
Zhonghua Gan Zang Bing Za Zhi. 2010 Jan;18(1):49-53. doi: 10.3760/cma.j.issn.1007-3418.2010.01.012.
To reassess the diagnostic value of 24 hour urinary copper excretion in children with Wilson disease (WD).
From July 2005 to June 2007, inpatients over three years old in a pediatric liver center were assigned into WD and non-WD group.
94 patients, including 26 cases in WD and 68 in non-WD group, were enrolled in this study. The median of 24 h urinary copper excretion was 98.5 microg in WD group and 25.8 microg in the non-WD group (Z = -6.111, P equal to 0.000). The area under receiver operator curve (ROC) was 0.909 (95% CI: 0.839-0.979, P equal to 0.000). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 84.6%, 91.2%, 89.4%, 78.6% and 93.9% respectively using 52.0 ug as a cutoff value, and 50.0%, 97.1%, 84.0%, 86.7% and 83.5% using 100 microg as a cutoff value. The goodness of fitness of 52 microg criteria was significantly higher than 100 microg criteria (kappacoefficient 0.760, 0.541 respectively, P equal to 0.000).
Comparing to 100, 52 microg of 24 h urinary copper excretion as a cutoff value significantly improves the sensitivity and accuracy for diagnosing WD in children.
重新评估24小时尿铜排泄量对肝豆状核变性（WD）患儿的诊断价值。
2005年7月至2007年6月，将某儿科肝脏中心3岁以上的住院患儿分为WD组和非WD组。
本研究共纳入94例患者，其中WD组26例，非WD组68例。WD组24小时尿铜排泄量中位数为98.5μg，非WD组为25.8μg（Z=-6.111，P=0.000）。受试者工作特征曲线（ROC）下面积为0.909（95%CI：0.839-0.979，P=0.000）。以52.0μg为临界值时，敏感度、特异度、准确度、阳性预测值和阴性预测值分别为84.6%、91.2%、89.4%、78.6%和93.9%；以100μg为临界值时，分别为50.0%、97.1%、84.0%、86.7%和83.5%。52μg标准的拟合优度显著高于100μg标准（卡帕系数分别为0.760、0.541，P=0.000）。
与100μg相比，24小时尿铜排泄量以52μg为临界值可显著提高儿童WD诊断的敏感度和准确度。
Zotero 插件