| ObjectiveBy detecting the level of serum IgG4 in patients with elevated IgG,to explore the expression level and clinical significance of serum IgG4 in patients with elevated IgG,in order to provide serological laboratory evidence for the diagnosis of patients with elevated IgG.MethodsA total of 589 patients whose serum IgG levels were higher than the upper limit of normal(17.4g/L)detected in the outpatient and inpatient departments of our hospital were included as the research subjects.Serum specimens and basic clinical data were collected,and the disease group(379 cases)and healthy controls were detected.Serum IgG4 of the group(210 cases).The patients were divided into liver disease group(154cases),enteropathy group(33 cases),gallbladder disease group(29 cases),pancreas disease group(26 cases),respiratory system disease group(39 cases),rheumatism group(39 cases)according to different disease types Sexual disease group(31 cases),nephropathy group(30 cases),blood disease group(9 cases),thyroid disease group(17cases),cardiovascular disease group(11 cases),and the serum levels of patients with different disease groups and healthy control groups were analyzed.IgG4 expression.Fasting cubital venous blood was drawn from all subjects in the morning,and serum IgG4 was detected by enzyme-linked immunosorbent assay.Results1.There was no significant difference in age and gender between the healthy control group and each disease group(P>0.05).2.Compared with the control group,the level of IgG4 in the rheumatic disease group(unit g/L)[0.317(0.226,0.700)] was higher than that in the control group [0.035(0.021,0.061)],the difference was statistically significant(P<0.05).Overall comparison of IgG4 levels in each group,IgG4 levels in other groups(liver disease group [0.033(0.014,0.078)],enteropathy group [0.027(0.011,0.059)],gallbladder disease group[0.041(0.013,0.093],pancreatic disease group [0.041(0.013,0.093)] group [0.018(0.005,0.050)],respiratory disease group [0.049(0.021,0.088)],kidney disease group[0.024(0.011,0.048)],blood disease group [0.024(0.019,0.159)],thyroid disease group[ 0.015(0.006,0.050)])compared with the rheumatic disease group,both were lower than the rheumatic disease group 0.317(0.226,0.700),the difference was statistically significant(P < 0.05).Cardiovascular disease group [0.110(0.020,0.120))] compared with the rheumatic disease group [0.317(0.226,0.700)],which was lower than the rheumatic disease group,and the difference was not statistically significant(P>0.05).3.The results of the predictive value of IgG4 levels in various diseases showed that for the pancreatic disease group,the AUC was 0.648(0.583-0.709),the specificity was92.38%,the Youden index was 0.3469,and the cut-off value was <0.01 g /L;for the rheumatic disease group,the AUC was 0.945(0.908-0.970),the sensitivity and specificity were 90.32% and 95.24%,respectively,and the cut-off value was >0.1671 g/L;for the renal disease group,the AUC was 0.634(0.570-0.695)with a high specificity of 89.52%and a cut-off value of ≤0.0125 g/L.ConclusionThe expression level of IgG4 in the rheumatic disease group was higher than that in the healthy control group and other disease groups,suggesting that the increase in IgG4 level tends to lead to rheumatic diseases.Quantitative detection of IgG4 levels has a good predictive value for pancreatic diseases,rheumatic diseases and kidney diseases,and provides serological laboratory evidence for the differential diagnosis of diseases,which has certain clinical significance. |
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