摘要
目的 分析过敏性紫癜(HSP)患儿血清中NLR、IL-33表达水平在评估肾脏损伤及远期复发中的临床价值。方法 选择2021年1月—2023年1月本院收治的HSP患儿180例和正常儿童(对照组)60名作为研究对象。根据HSP患儿是否发生肾脏损伤,分为HSP组(n=109)和HSP肾脏损伤组(n=71)。患儿随访至少1年,HSP患儿出现复发定义为复发组(n=35),未出现复发定义为未复发组(n=145)。记录所有研究对象NLR和IL-33表达水平。HSP患儿发生肾脏损伤的危险因素采用Logistic分析,NLR和IL-33在诊断HSP患儿发生肾脏损伤及预测HSP患儿复发的临床效能采用受试者操作特征曲线分析。结果 对照组、HSP组和HSP伴肾脏损伤组三组血清中NLR和IL-33表达水平存在明显差异(P<0.05);与对照组相比,NLR、IL-33在HSP组和HSP伴肾脏损伤组中明显升高(P<0.05);与HSP组相比,NLR、IL-33在HSP伴肾脏损伤组中明显升高(P<0.05)。与HSP组相比,HSP伴肾脏损伤组中伴有腹痛和(或)关节痛占比、WBC、N、NLR、hs-CRP和IL-33表达水平均有所升高,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,NLR(OR=2.871,P<0.05)、IL-33(OR=3.211,P<0.05)是HSP发生肾脏损伤的独立危险因素。NLR和IL-33在诊断HSP发生肾脏损伤的AUC分别为0.804和0.921,NLR诊断敏感度和特异度为80.34%和85.82%,IL-33诊断敏感度和特异度分别为90.45%和93.18%。与未复发组相比,复发组HSP患儿NLR和IL-33表达水平明显升高,差异具有统计学意义(P<0.05)。NLR和IL-33预测HSP患儿出现复发的AUC分别为0.911和0.918,NLR预测敏感度和特异度分别为90.12%和90.35%,IL-33预测敏感度和特异度分别为91.23%和89.49%。结论 HSP患儿外周血中NLR和IL-33表达水平明显升高,NLR和IL-33与HSP患儿肾脏损伤及远期复发密切相关。
Objective To analyze the clinical value of serum NLR and IL-33 expression levels in evaluating renal injury and long-term recurrence in children with Henoch-Schonlein purpura(HSP).Methods A total of 180 children with HSP who were admitted to the First Affiliated Hospital of Wannan Medical College(Yijishan Hospital)from January 2021 to January 2023 and 60 normal children(the control group)were included as study subjects.The HSP children were further divided into HSP group(n=109)and HSP complicated with renal injury group(n=71)according to the incidence of renal injury.All HSP children were followed up for at least 1 year.The children with HSP recurrence were defined as the recurrence group(n=35)and the remaining were defined as the non-recurrence group(n=145).The expression levels of NLR and IL-33 were recorded in all individuals.The risk factors of renal injury in children with HSP were analyzed by Logistic analysis,and the clinical efficacy of NLR and IL-33 in diagnosing the incidence of renal injury and predicting the HSP recurrence in children with HSP was analyzed by received operation characteristic curve.Results The difference in serum expression levels of NLR and IL-33 among the control group,HSP group and HSP complicated with renal injury group were significantly different(P<0.05).Compared with the control group,NLR and IL-33 expression were significantly increased in HSP group and HSP complicated with renal injury group(P<0.05).Compared with HSP group,NLR and IL-33 were significantly increased in HSP complicated with renal injury group(P<0.05).Compared with HSP group,the proportion of abdominal pain and/or joint pain,the levels of WBC,N,NLR,hs-CRP and IL-33 in HSP complicated with renal injury group were significantly increased,with statistical significance ( P <0.05).The Logistic regression analysis showed that NLR ( OR =2.871, P <0.05) and IL-33 ( OR =3.211 , P <0.05) were independent risk factors for renal injury in children with HSP.The AUC of NLR and IL-33 in the diagnosis of renal injury in HSP were 0.804 and 0.921,respectively;the diagnostic sensitivity and specificity of NLR were 80.34% and 85.82%,and the diagnostic sensitivity and specificity of IL-33 were 90.45% and 93.18%,respectively.Compared with the non-recurrence group,the serum expression levels of NLR and IL-33 in the recurrence group were significantly increased,with statistical significance ( P <0.05).The AUC of NLR and IL-33 in predicting the disease recurrence in HSP children was 0.911 and 0.918,the predicting sensitivity and specificity of NLR were 90.12% and 90.35%,and the predicting sensitivity and specificity of IL-33 were 91.23% and 89.49%.Conclusions The expression levels of NLR and IL-33 in peripheral blood of children with HSP were significantly increased,and NLR and IL-33 were closely related to renal injury and long-term recurrence in children with HSP.
作者
贾妮旦
程彩虹
卢晓红
江佳慧
袁涛
Jia Nidan;Chen Caihong;Lu Xiaohong;Jiang Jiahui;Yuan Tao(Department of Pediatrics,the First Affiliated Hospital of Wannan Medical College(Yijishan Hospital),Wuhu,Anhui 241004,China;Department of Dermatology,the First Affiliated Hospital of Wannan Medical College(Yijishan Hospital),Wuhu,Anhui 241004,China)
出处
《齐齐哈尔医学院学报》
2024年第9期813-817,共5页
Journal of Qiqihar Medical University
基金
2023年安徽省自然科学基金青年基金(2308085QH269)。
