摘要
目的 探讨儿童狼疮性肾炎(LN)外周血白细胞介素-6(IL-6)、血沉(ESR)、CD4^(+)/CD8^(+)水平变化及其预测价值。方法 选取2019年1月—2022年9月我院收治的120例LN患儿作为观察组,另选取同期体检健康儿童120例作为对照组。比较两组外周血IL-6、ESR、CD4^(+)/CD8^(+),分析外周血IL-6、ESR、CD4^(+)/CD8^(+)与系统性红斑狼疮(SLE)疾病活动度(SLEDAI)的相关性,比较不同预后患儿外周血IL-6、ESR、CD4^(+)/CD8^(+),分析LN患儿预后影响因素,评价外周血IL-6、ESR、CD4^(+)/CD8^(+)对LN患儿预后的预测价值。结果 观察组外周血IL-6、ESR高于对照组,CD4^(+)/CD8^(+)低于对照组(P<0.05);LN患儿外周血IL-6、ESR与SLEDAI评分呈正相关,CD4^(+)/CD8^(+)与SLEDAI评分呈负相关(P<0.05);预后不良外周血IL-6、ESR高于预后良好,CD4^(+)/CD8^(+)低于预后良好(P<0.05);SLEDAI评分、IL-6、ESR、CD4^(+)/CD8^(+)均为LN患儿预后影响因素(P<0.05);外周血IL-6、ESR、CD4^(+)/CD8^(+)预测LN患儿预后的AUC分别为0.777、0.751、0.788,联合预测AUC为0.921(均P<0.001);进一步对各预测方案预测价值比较显示,外周血IL-6、ESR、CD4^(+)/CD8^(+)联合预测的AUC明显高于单一指标(均P<0.05)。结论 LN患儿外周血IL-6、ESR水平较高,CD4^(+)/CD8^(+)水平下降,且与SLEDAI评分及预后有关,临床检测其水平,可作为LN病情评估及预后预测的血液生化指标,为临床工作提供参考依据。
Objective To observe the changes in peripheral blood IL-6,sedimentation(ESR) and CD4^(+)/CD8^(+) levels in children with lupus nephritis(LN) and their predictive value.Methods A total of 120 children with LN admitted to our hospital from January 2019 to September 2022 were selected as the observation group,and another 120 healthy children during the same period were selected as the control group.Peripheral blood IL-6,ESR,CD4^(+)/CD8^(+) were compared between the two groups,and the correlation between peripheral blood IL-6,ESR,CD4^(+)/CD8^(+) and systemic lupus erythematosus(SLE) disease activity(SLEDAI) was analyzed.Peripheral blood IL-6,ESR,CD4^(+)/CD8^(+) of children with different prognosis were compared,and prognostic factors of children with LN were analyzed.To evaluate the prognostic value of peripheral blood IL-6,ESR and CD4^(+)/CD8^(+) in children with LN.Results Peripheral blood IL-6,ESR in observation group were higher than those in control group,CD4^(+)/CD8^(+) were lower than those in control group(P<0.05).Peripheral blood IL-6,ESR was positively correlated with SLEDAI score,CD4^(+)/CD8^(+) was negatively correlated with SLEDAI score(P<0.05).Peripheral blood IL-6,ESR were higher than good prognosis,CD4^(+)/CD8^(+) was lower than good prognosis(P<0.05).SLEDAI score,IL-6,ESR,CD4^(+)/CD8^(+) were prognostic factors in LN patients(P<0.05).The AUC of peripheral blood IL-6,ESR and CD4^(+)/CD8^(+) in predicting the prognosis of LN children was 0.777,0.751 and 0.788,respectively,and the combined AUC was 0.921(all P<0.001).Further comparison of the predictive value of all prediction schemes showed that AUC predicted by the combination of IL-6,ESR and CD4^(+)/CD8^(+) in peripheral blood was significantly higher than that predicted by a single index(all P<0.05).Conclusion Peripheral blood IL-6,ESR levels were higher and CD4^(+)/CD8^(+) levels were decreased in children with LN,which was correlated with SLEDAI score and prognosis.Clinical detection of ESR levels can be used as a blood biochemical index for disease assessment and prognosis prediction of LN,providing a reference for clinical work.
作者
杨米凤
廖亚彬
蒋雪梅
崔晶晶
毕欣
赵波
YANG Mifeng;LIAO Yabin;JIANG Xuemei;CUI Jingjing;BI Xin;ZHAO Bo(Department of Nephrology,Kunming Children's Hospital,Kunming 650200,China)
出处
《西部医学》
2024年第3期433-437,共5页
Medical Journal of West China
基金
昆明市卫生科技项目[2018-SW(技)-18]。
