过敏性紫癜患儿血清Gd-IgA1、TGF-β1及IGF-1指标联合检测及其临床意义  

Combined detection of serum Gd-IgA1,TGF-β1 and IGF-1 and their clinical significance in children patients with Henoch-Schonlein purpura

作　　者：刘玉娇 连换杰 李涛[1] LIU Yu-jiao;LIAN Huan-jie;LI Tao(Department of Pediatrics,Taihe Hospital,Shiyan Hubei 442000,China)

机构地区：[1]十堰市太和医院儿科,湖北十堰442000

出　　处：《临床和实验医学杂志》2021年第19期2098-2101,共4页Journal of Clinical and Experimental Medicine

基　　金：湖北省卫生厅科研项目(编号:1409304)。

摘　　要：目的研究过敏性紫癜(HSP)患儿血清半乳糖缺陷IgA1(Gd-IgA1)、转化生长因子β1(TGF-β1)和胰岛素样生长因子-1(IGF-1)表达水平及与肾脏损伤的关系,然后分析3项指标联合检测对紫癜性肾炎(HSPN)诊断价值。方法回顾性选取2016年10月至2020年10月十堰市太和医院收治的HSP患儿108例,其中HSPN组56例,非HSPN组52例,另选取同期健康体检儿童60例作为对照组。根据24 h尿蛋白定量将HSPN患儿分为Ⅰ组(<25 mg/kg)、Ⅱ组(25~50 mg/kg)和Ⅲ组(>50 mg/kg)。分别检测免疫球蛋白(IgA、IgG和IgM),补体C3、C4,血清Gd-IgA1、TGF-β1和IGF-1水平及24 h尿蛋白定量,分析血清Gd-IgA1、TGF-β1和IGF-1水平与24 h尿蛋白定量相关性及其对HSPN诊断价值。结果HSP患儿血清IgA、IgG、C3和C4水平明显高于对照组,差异均有统计学意义(P<0.05),且HSPN组和非HSPN组差异无统计学意义(P>0.05);HSPN组血清Gd-IgA1、TGF-β1和IGF-1水平高于非HSPN组,差异均有统计学意义(P<0.05);Ⅰ~Ⅲ组HSPN患者血清Gd-IgA1、TGF-β1和IGF-1水平和24 h尿蛋白定量均明显升高(P<0.05),且各组差异均有统计学意义(P<0.05);HSPN患者血清Gd-IgA1、TGF-β1及IGF-1水平与24 h尿蛋白定量均具有明显正相关性(P<0.05);血清Gd-IgA1、TGF-β1、IGF-1水平及联合检测诊断HSPN的AUC分别为0.829、0.759、0.792和0.930,敏感度分别为67.86%、62.50%、75.00%和83.93%,特异度分别为92.31%、86.54%、71.15%和90.38%。结论HSP患儿血清Gd-IgA1、TGF-β1和IGF-1水平明显升高,且与肾脏损伤存在密切联系,对诊断HSPN具有良好参考价值。Objective To study the expression levels of serum galactose-deficient IgA1(Gd-IgA1),transforming growth factorβ1(TGF-β1)and insulin-like growth factor-1(IGF-1)in children patients with Henoch-Schonlein purpura(HSP)and their relationship with kidney injury,and then analyze the diagnostic value of the combined detection of the three indicators on Henoch-Schonlein purpura nephritis(HSPN).Methods A total of 108 children patients with HSP in Taihe Hospital from October 2016 to October 2020 were retrospectively selected,including 56 cases in HSPN group and 52 cases in non-HSPN group.Another 60 healthy children with physical examination in our hospital during the same period were selected ascontrol group.According to 24 h urine protein quantification,children with HSPN were divided into groupⅠ(<25 mg/kg),groupⅡ(25-50 mg/kg)and groupⅢ(>50 mg/kg).And immunoglobulins(IgA,IgG and IgM),complements C3 and C4,levels of serum Gd-IgA1,TGF-β1 and IGF-1 and 24 h urine protein quantification were detected,and the correlation between levels of serum Gd-IgA1,TGF-β1 and IGF-1 and 24 h urine protein quantification and the diagnostic value of three levelson HSPN were analyzed.Results The levels of serum IgA,IgG,C3 and C4 in children patients with HSP were significantly higher than those in control group(P<0.05),and there were no significant differences between HSPN group and non-HSPN group(P>0.05).The levels of serum Gd-IgA1,TGF-β1 and IGF-1 in HSPN group were higher than those in non-HSPN group(P<0.05).The levels of serum Gd-IgA1,TGF-β1 and IGF-1 and 24 h urine protein quantification in patients with HSPN in groups I~III were significantly increased(P<0.05),and the differences in each group were statistically significant(P<0.05).The levels of serum Gd-IgA1,TGF-β1 and IGF-1 in patients with HSPN were significantly positively correlated with 24 h urine protein quantification(P<0.05).The AUC values of serum Gd-IgA1,TGF-β1,IGF-1 and combined detection in the diagnosis of HSPN were 0.829,0.759,0.792 and 0.930 respectively,and

关 键 词：过敏性紫癜 紫癜性肾炎 半乳糖缺陷IgA1 转化生长因子β1 胰岛素样生长因子-1 24 h尿蛋白定量 

分 类 号：R725.5[医药卫生—儿科]