血清IL-18、IGF-1水平对丙种球蛋白治疗过敏性紫癜肾炎患儿预后的预测价值  

Predictive Value of Serum IL-18 and IGF-1 Levels on the Prognosis of Gamma Globulin in Children with Henoch-schonlein Purpura Nephritis

作　　者：李艳佳 张果果 LI Yanxia;ZHANG Guoguo(Department of Paediatrics,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院儿科,河南洛阳471000

出　　处：《河南医学研究》2021年第21期3879-3882,共4页Henan Medical Research

摘　　要：目的探讨血清白介素-18(IL-18)、胰岛素样生长因子-1(IGF-1)水平对丙种球蛋白治疗过敏性紫癜肾炎(HSPN)患儿预后的预测价值。方法选取2018年9月至2020年9月河南科技大学第一附属医院收治的68例HSPN患儿为研究对象。在常规治疗基础上联合丙种球蛋白治疗,治疗1个月,评估预后情况;检测患儿治疗前、治疗1个月后的血清IL-18、IGF-1水平,分析血清IL-18、IGF-1水平对丙种球蛋白治疗HSPN患儿预后的评估价值。结果68例HSPN患儿经丙种球蛋白治疗后,显效29例,有效19例,无效20例。预后良好组48例,占70.59%(48/68),预后不良组20例,占29.41%(20/68)。治疗1个月后,两组血清IL-18、IGF-1水平均低于治疗前,且预后不良组治疗前、治疗1个月后血清IL-18、IGF-1水平均高于预后良好组,差异有统计学意义(P<0.05)。经logistic回归分析结果显示,血清IL-18、IGF-1水平高表达可增加丙种球蛋白治疗HSPN患儿预后不良的风险(OR>1,P<0.05)。经Pearson相关性分析,HSPN患儿血清IL-18与IGF-1水平呈正相关(r=0.493,P<0.001)。绘制受试者工作曲线(ROC)结果显示,治疗前血清IL-18、IGF-1水平单独及联合评估丙种球蛋白治疗HSPN患儿预后不良的曲线下面积(AUC)分别为0.749、0.755、0.793,均有一定的评估价值,且联合评估的价值更高。结论血清IL-18、IGF-1水平与丙种球蛋白治疗HSPN患儿预后存在一定联系,且两指标对预测丙种球蛋白治疗HSPN患儿预后不良具有一定的价值。Objective To investigate the predictive value of serum interleukin-18(IL-18)and insulin-like growth factor-1(IGF-1)levels on the prognosis of children with henoch-schonlein purpura nephritis(HSPN)treated with gamma globulin.Methods A total of 68 children with HSPN admitted to the First Affiliated Hospital of Henan University of Science and Technology from September 2018 to September 2020 were selected as the research subjects.On the basis of conventional treatment combined with gamma globulin treatment,the prognosis were evaluated after treatment for 1 month.Serum IL-18 and IGF-1 levels were detected before and after 1 month of treatment,and the effect of serum IL-18 and IGF-1 levels on the prognosis of gamma globulin treatment in HSPN children were analyzed.Results After the 68 HSPN children were treated with immunoglobulin,29 cases were significantly effective,19 cases were effective,20 cases were ineffective.A total of 48 cases had good prognosis(70.59%,48/68,good prognosis group),and 20 cases had poor prognosis(29.41%,20/68,poor prognosis group).After 1 month of treatment,the levels of serum IL-18 and IGF-1 in both groups were lower than before treatment,and the levels of serum IL-18 and IGF-1 in the poor prognosis group were higher than those in the good prognosis group before and after 1 month of treatment(P<0.05).Logistic regression analysis showed that high expression of serum IL-18 and IGF-1 increased the risk of poor prognosis in children with HSPN treated with gamma globulin(OR>1,P<0.05).By Pearson correlation analysis,serum IL-18 and IGF-1 levels in HSPN children were positively correlated(r=0.493,P<0.001).The results of receiver operating curve(ROC)showed that the area under the curve(AUC)of serum IL-18 and IGF-1 levels before treatment to evaluate the poor prognosis of IGF-1 in children with HSPN were 0.749,0.755 and 0.793 respectively,both of which had certain evaluation value,and the value of combined evaluation was higher.Conclusion Serum IL-18 and IGF-1 levels are associated with the prognosis o

关 键 词：过敏性紫癜肾炎 丙种球蛋白 白介素-18 胰岛素样生长因子-1 相关性 

分 类 号：R725[医药卫生—儿科]