儿童紫癜性肾炎的相关因素及血清IgA/C3的预测价值分析  

Analysis of correlative factors and predictive value of serum IgA/C3 ratio for Henoch-Schonlein purpura nephritis in children

作　　者：畅晓元[1] 刘岩[1] CHANG Xiao-yuan;LIU Yan(Department of Dermatology, Shenyang Seventh People’s Hospital,Shenyang 110003,China)

机构地区：[1]沈阳市第七人民医院皮肤科

出　　处：《实用药物与临床》2019年第9期956-959,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨儿童紫癜性肾炎(Henoch-Schonlein purpura nephritis,HSPN)的相关因素和血清IgA/C3的预测价值。方法回顾性分析我院2016年6月至2018年11月收治的137例过敏性紫癜患儿的临床及实验室检查资料,包括性别,年龄,皮疹分布范围,消化道症状,血常规白细胞,血小板计数,血清IgA、IgG、IgM,血清补体(C3、C4),抗链球菌溶血素O(ASO),C反应蛋白(CRP),纤维蛋白原(FIB),D2聚体(DD),尿常规及24 h尿蛋白定量,根据尿化验结果分成HSPN组(52例)和非HSPN组(85例)。结果单因素分析提示,HSPN组年龄≥7岁、皮疹分布累及躯干及上肢、出现消化道症状的比例多于非HSPN组(P<0.05,P<0.01),血清免疫球蛋白IgA水平高于非HSPN组(P<0.01)。进一步Logistic回归分析提示,皮疹分布范围广、出现消化道症状和血清免疫球蛋白IgA水平升高与HSPN相关。IgA/C3预测HSPN的曲线下面积(AUC)大于IgA。结论皮疹分布范围广、出现消化道症状和血清免疫球蛋白IgA水平升高可能是HSPN的高危因素。IgA/C3预测HSPN的效能可能优于IgA。Objective To explore the correlative factors and predictive value of serum IgA/C3 ratio for Henoch-Sch?nlein purpura nephritis(HSPN)in children.Methods Totally 137 HSP children were enrolled in this study from June 2016 to November 2018 in our hospital.Clinical and laboratory data were retrospectively analyzed including gender,age,distribution of erythra,gastrointestinal symptoms,levels of leukocytes,platelets,serum IgA,IgG,IgM,complement compotent C3,C4,antistreptolysin O,C-reaction protein(CRP),fibrinogen(FIB),D-dimer(DD)and urinary protein assay.Patients were grouped into HSPN group(n=52)or non-HSPN group(n=85)according to the urinary protein analysis.Results Ratios of age≥7,rashes beyond lower limbs,gastrointestinal symptoms and IgA levels were higher in HSPN group than innon-HSPN group by single factor analysis.Logistic regression indicated that larger erythra distribution,gastrointestinal sympotoms and increased IgA were related to HSPN.Area under curve(AUC)of IgA/C3 for predicting HSPN was larger than that of IgA alone.Conclusion Larger erythra distribution,gastrointestinal symptoms and increased IgA are probably risk factors of HSPN.Sensitivity of IgA/C3 for predicting HSPN is likely higher than IgA alone.

关 键 词：儿童 紫癜性肾炎 相关因素 免疫球蛋白A 补体C3 

分 类 号：R726.9[医药卫生—儿科]