外周血免疫球蛋白及抗心磷脂抗体水平检测对紫癜性肾炎患儿预后评估的价值分析  

Levels of peripheral blood immunoglobulin and anticardiolipin antibody in evaluation of prognosis of children with purpuric nephritis

作　　者：杨建伟[1] Yang Jianwei(Key Laboratory of Children’s Infection and Immunology in Zhengzhou,Children’s Hosital,Zhengzhou University(Henan Children’s Hospital,Zhengzhou Children’s Hospital),Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院,郑州市儿童感染与免疫重点实验室,450000

出　　处：《国际医药卫生导报》2020年第20期3100-3103,共4页International Medicine and Health Guidance News

摘　　要：目的探究外周血免疫球蛋白(Ig)、抗心磷脂抗体(ACA)水平对紫癜性肾炎(HSPN)患儿预后评估的价值。方法选取本院2017年5月至2019年5月确诊的过敏性紫癜(HSP)患儿104例,其中非HSPN患儿75例为HSP组,HSPN患儿29例为HSPN组,均进行外周血免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白D(IgD)、免疫球蛋白E(IgE)及抗心磷脂抗体IgG(ACA-IgG)、抗心磷脂抗体IgA(ACA-IgA)、抗心磷脂抗体IgM(ACA-IgM)检测,并分析其与HSPN患儿预后相关性。结果两组患儿年龄、性别、BMI及并发症情况比较,差异均无统计学意义(均P>0.05);两组患儿IgA、IgM水平比较,差异均无统计学意义(均P>0.05);HSPN组患儿IgG、IgD及IgE水平分别为(7.58±2.53)g/L、(66.32±9.33)mg/L、(69.24±6.33)mg/L,均显著低于HSP组(11.06±4.13)g/L、(83.25±10.36)mg/L、(78.36±7.44)mg/L,差异均有统计学意义(均P<0.05);HSPN组患儿ACA-IgG、ACA-IgA及ACA-IgM水平分别为(99.28±15.22)U/ml、(178.58±24.31)U/ml、(103.36±15.23)U/ml,均显著高于HSP组(87.89±14.88)U/ml、(157.56±15.13)U/ml、(82.65±16.68)U/ml,差异均有统计学意义(均P<0.05);HSPN组患儿中,预后达A级者7例、B级者9例、C级者8例、D级者5例,随着患儿预后等级不断增加,HSPN组IgG、IgD、IgE指标均依次下降,ACA-IgG、ACA-IgA及ACA-IgM指标均依次升高,差异均有统计学意义(均P<0.05);IgG、IgD、IgE水平与HSPN患儿预后等级呈显著正相关,差异有统计学意义(P<0.05);ACA-IgG、ACA-IgA、ACA-IgM水平与HSPN患儿预后等级呈显著负相关,差异有统计学意义(P<0.05)。结论Ig及ACA水平可反映HSPN患儿病症程度,检测HSPN组患儿Ig及ACA水平可为诊断患儿病情评估提供一定的参考。Objective To explore the value of levels of peripheral blood immunoglobulin(Ig)and anticardiolipin antibody(ACA)in prognostic evaluation of children with Henoch Schonlein purpura nephritis(HSPN).Methods A total of 104 children with Henoch Schonlein purpura(HSP)diagnosed at our hospital between May,2017 and May,2019 were selected.Among them,75 children without HSPN were included in an HSP group,and 29 children with HSPN an HSPN group.The peripheral blood immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin D(IgD),immunoglobulin E(IgE),anticardiolipin antibody IgG(ACA-IgG),anticardiolipin antibody IgA(ACA-IgA),and anticardiolipin antibody IgM(ACA-IgM)were detected.The correlation between the above indicators and the prognosis of the children with HSPN was analyzed.Results The were no statistical differences in age,gender,BMI,and complications between these two groups(all P>0.05).The were no statistical differences in the levels of IgA and IgM between the two groups(both P>0.05).The levels of IgG,IgD,and IgE in the HSPN group were significantly lower than those in the HSP group[(7.58±2.53)g/L vs.(11.06±4.13)g/L,(66.32±9.33)mg/L vs.(83.25±10.36)mg/L,and(69.24±6.33)mg/L vs.(78.36±7.44)mg/L;all P<0.05].The levels of ACA-IgG,ACA-IgA,and ACA-IgM were significantly higher in the HSPN group than in the HSP group[(99.28±15.22)U/ml vs.(87.89±14.88)U/ml,(178.58±24.31)U/ml vs.(157.56±15.13)U/ml,and(103.36±15.23)U/ml vs.(82.65±16.68)U/ml;all P<0.05].In the HSPN group,7 cases got grade A prognosis,9 grade B,8 grade C,and 5 grade D;as the prognosis grade increased,the levels of IgG,IgD,and IgE decreased,and the levels of ACA-IgG,ACA-IgA,and ACA-IgM increased(all P<0.05).The prognostic grade of the children with HSPN were positively correlated with the levels of IgG,IgD,and IgE(all P<0.05),and negatively with ACA-IgG,ACA-IgA,and ACA-IgM(all P<0.05).Conclusion The levels of Ig and ACA can reflect the severity of HSPN in children.The detection of Ig and ACA in children with HSPN can provide di

关 键 词：外周血免疫球蛋白 抗心磷脂抗体 紫癜性肾炎患儿 预后 

分 类 号：R726.9[医药卫生—儿科]