血清Gd-IgA1、IL-6水平对儿童紫癜性肾炎的诊断效能  

Diagnostic value of serum Gd-IgA1 and IL-6 levels for HSPN in children

作　　者：徐闪闪[1] 丁樱[1,2] 韩姗姗[1] 代彦林 张霞[1,2] XU Shanshan;DING Ying;HAN Shanshan;DAI Yanlin;ZHANG Xia(School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450000,China;不详)

机构地区：[1]河南中医药大学儿科医学院,郑州450000 [2]河南中医药大学第一附属医院儿科

出　　处：《山东医药》2021年第36期19-22,共4页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81873343);河南省中医药科学研究专项课题(2019ZY1010)。

摘　　要：目的分析治疗前血清异常糖基化的IgA1-(Gd-IgA1)、白细胞介素6(IL-6)水平对儿童紫癜性肾炎(HSPN)的诊断效能。方法选择HSPN患儿45例(A组),过敏性紫癜(HSP)患儿15例(B组),同期健康体检儿童15例(C组),比较各组血清Gd-IgA1和IL-6水平,分析A组患儿治疗前血清Gd-IgA1、IL-6水平之间及其与24 h尿蛋白、肾脏病理的相关性,另分析治疗前血清Gd-IgA1、IL-6水平对HSPN的诊断作用。结果与C组比较,A组,血清Gd-IgA1、IL-6水平和B组血清IL-6水平升高(P均<0.05);与B组比较,A组治疗前血清Gd-IgA1、IL-6水平升高(P均<0.05)。与治疗前比较,A组治疗后血清Gd-IgA1、IL-6水平降低(P均<0.05)。A组患儿治疗前血清Gd-IgA1水平与24 h尿蛋白定量呈正相关(r=0.43,P<0.05),血清IL-6水平与24 h尿蛋白定量无相关性(P>0.05);A组患儿治疗前血清Gd-IgA1水平与肾脏病理等级呈正相关(r=0.43,P<0.05),血清IL-6水平与肾脏病理等级无相关性(r=0.24,P>0.05);血清Gd-IgA1水平与血清IL-6水平呈正相关(r=0.51,P<0.05)。当治疗前血清Gd-IgA1截点为3235.26 ng/mL时,其诊断HSPN的灵敏度为0.956,特异度为0.8,ROC曲线下面积为0.879;当治疗前血清IL-6截点为21.88 pg/mL时,其诊断HSPN的灵敏度为0.49,特异度为0.87,ROC曲线下面积为0.65。结论治疗前血清Gd-IgA1及IL-6对儿童HSPN有诊断效能。Objective To analyze the diagnostic value of abnormal glycosylated IgA1(Gd-IgA1)and interleukin-6(IL-6)levels for Henoch-Schonlein purpura nephritis(HSPN)in children before treatment.Methods Forty-five children with HSPN(group A),15 children with Henoch-Schonlein purpura(HSP)(group B),and 15 children with healthy physical examination during the same period(group C)were selected,and the serum levels of Gd-IgA1 and IL-6 in each group were compared.We analyzed the serum Gd-IgA1 and IL-6 levels of children and their correlations with 24 h urine protein and renal pathology,and analyzed the value of serum Gd-IgA1 and IL-6 levels for the diagnosis of HSPN.Results Compared with group C,the serum Gd-IgA1 and IL-6 levels in the group A and serum IL-6 level in the group B increased(all P<0.05);compared with group B,the serum Gd-IgA1 and IL-6 levels increased in the group A(both P<0.05).After treatment,the serum Gd-IgA1 and IL-6 levels decreased in the group A(both P<0.05).The serum Gd-IgA1 level of children in the group A was positively correlated with 24-hour urine protein quantification(r=0.43,P<0.05),and there was no correlation between serum IL-6 level and 24-h urine protein quantification(P>0.05).The serum Gd-IgA1 level of children in the group A was positively correlated with renal pathological grade(r=0.43,P<0.05),but serum IL-6 level was not correlated with renal pathological grade(r=0.24,P>0.05);serum Gd-IgA1 level was positively correlated with serum IL-6 level(r=0.51,P<0.05).When the cut-off point of serum Gd-IgA1 was 3235.26 ng/mL,the sensitivity for diagnosing HSPN was 0.956,the specificity was 0.8,and the area under the ROC curve was 0.879;when the cut-off point of acute-phase serum IL-6 was 21.88 pg/mL,the sensitivity for diagnosing HSPN was 0.49,the specificity was 0.87,and the area under the ROC curve was 0.65,respectively.Conclusion Serum Gd-IgA1 and IL-6 levels have a diagnostic value on HSPN in children before treatment.

关 键 词：异常糖基化免疫球蛋白A 白细胞介素6 紫癜性肾炎 

分 类 号：R725.1[医药卫生—儿科]