摘要
目的探讨T淋巴细胞亚群及血浆细胞因子检测指标对儿童特发性血小板减少性紫癜(ITP)的诊断价值。方法选择2018年2月至2020年9月该院收治的血小板减少的住院患儿92例。所有患儿均进行T淋巴细胞亚群及血浆细胞因子检测,参照《诸福棠实用儿科学(第8版)》的规定对ITP进行诊断,根据ITP诊断结果将患儿分为ITP组和非ITP组,比较两组患儿T淋巴细胞亚群及血浆细胞因子水平,并以受试者工作特征(ROC)曲线评估各指标单独检测与联合检测对ITP的诊断价值。结果92例患儿中共62例(67.39%)被诊断为ITP,2组患儿性别、年龄、病程、血小板计数水平比较,差异均无统计学意义(P>0.05)。ITP组患儿CD3^(+)及CD4^(+)水平均低于非ITP组,CD8^(+)水平高于非ITP组,差异均有统计学意义(P<0.05)。ITP组患儿血浆白细胞介素(IL)-4水平低于非ITP组,IL-2、肿瘤坏死因子α(TNF-α)水平高于非ITP组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,CD3^(+)、CD4^(+)、CD8^(+)、IL-2、IL-4、TNF-α对儿童ITP的截断值分别为59.13%、26.04%、24.08%、4.05 pg/mL、3.74 pg/mL、4.19 pg/mL;曲线下面积(AUC)分别为0.883、0.528、0.806、0.875、0.759、0.506。六者联合诊断的AUC为0.932,其诊断效能高于各指标单独检测(P<0.05)。结论CD3^(+)、CD4^(+)、CD8^(+)、IL-2、IL-4、TNF-α均可作为儿童ITP的诊断指标,联合检测可提高诊断效能。
Objective To explore the diagnostic value of T lymphocyte subsets and plasma cytokine detection indexes in children with idiopathic thrombocytopenic purpura(ITP).Methods A total of 92 hospitalized children with thrombocytopenia admitted to this hospital from February 2018 to September 2020 were selected.All children were tested for T lymphocyte subsets and plasma cytokines,and ITP was diagnosed according to the regulations of Zhu Futang Practice of Pediatrics(8th Edition).According to the results of the ITP diagnosis,the children were divided into two groups.Those diagnosed with ITP were defined as the ITP group,and those who did not meet the ITP diagnosis were defined as the non-ITP group.The T lymphocyte subsets and plasma cytokine levels of the two groups were compared,and the diagnostic value of individual detection and combined detection of each index in ITP was evaluated by the receiver operating characteristic curve(ROC)method.Results A total of 62 of the 92 children were diagnosed with ITP(67.39%).There was no significant difference in gender,age,course of the disease,and platelet count between the two groups(P>0.05).The CD3^(+)and CD4^(+)levels of the children in the ITP group were lower than those in the non-ITP group,while the CD8^(+)level of children in the ITP group was higher than that in the non-ITP group,and the difference was statistically significant(P<0.05).The level of plasma interleukin-4 in the ITP group was lower than that in the non-ITP group,and the levels of interleukin-2 and tumor necrosis factorαin the ITP group were higher than those in the non-ITP group(P<0.05).The ROC analysis results showed that the cut-off values of CD3^(+),CD4^(+),CD8^(+),interleukin-2,interleukin-4,and tumor necrosis factorαon children′s ITP were 59.13%,26.04%,24.08%,4.05 pg/mL,3.74 pg/mL,4.19 pg/mL,respectively;the area under the curve(AUC)were 0.883,0.528,0.806,0.875,0.759,0.506,respectively.The AUC of the six combined diagnosis was 0.932,and its diagnostic efficiency was higher than that of each index alone(P<0.05).Conclusion CD3^(+),CD4^(+),CD8^(+),interleukin-2,interleukin-4,and tumor necrosis factorαcan all be used as diagnostic indexes for children′s ITP,and combined detection can improve the diagnostic efficiency.
作者
江南静
雷勋明
庞英
朱书瑶
皮光环
陈艾
JIANG Nanjing;LEI Xunming;PANG Ying;ZHU Shuyao;PI Guanghuan;CHEN Ai(Department of Pediatric,Sichuan Provincial Maternity and Child Health Care Hospital/Sichuan Women and Children′S Hospital/Women and Children′S Hospital Affiliated to Chengdu Medical College,Chengdu,Sichuan 600031,China)
出处
《重庆医学》
CAS
2022年第3期398-401,408,共5页
Chongqing medicine
基金
四川省重点研发项目(2019YFS0531)。
