过敏性紫癜患儿血清miR-374b表达水平及其与并发肾炎的相关性  

Expression level of serum miR-374b in children with Henoch Schonlein purpura and its correlation with nephritis

作　　者：张书锋[1] 刘翠华[1] 刘玉洁[1] 江春亚 贾东华 李玉柳 刘钧菲[1] 田明 曹广海 ZHANG Shufeng;LIU Cuihua;LIU Yujie;JIANG Chunya;JIA Donghua;LI Yuliu;LIU Junfei;TIAN Ming;CAO Guanghai(Department of Renal Rheumatology and Immunology,Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital Zhengzhou Children's Hospital,Zhengzhou,450018 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肾脏风湿免疫科,郑州450018

出　　处：《中国循证儿科杂志》2022年第1期61-65,共5页Chinese Journal of Evidence Based Pediatrics

摘　　要：背景过敏性紫癜常可累及肾脏,引发紫癜性肾炎,其远期预后与患儿肾脏受累程度关系密切,及早评估并发肾炎的可能性并给予针对性干预具有重要意义。目的探讨过敏性紫癜患儿血清miR-374b表达水平及其与并发肾炎的相关性。设计病例对照研究。方法病例组纳入过敏性紫癜患儿,分为并发肾炎亚组和未并发肾炎亚组;对照组纳入体检健康儿童;两组年龄均≤14岁。采集病例组和对照组儿童外周静脉血各5 mL,采用实时荧光定量PCR法检测miR-374b水平。从病历资料中截取病例组患儿的临床资料,从体检记录中截取对照组儿童的人口学资料。分析过敏性紫癜患儿并发肾炎的影响因素,采用ROC曲线分析血清miR-374b水平对过敏性紫癜患儿并发肾炎的诊断价值。主要结局指标血清miR-374b水平。结果病例组103例,男58例,平均年龄(7.2±1.2)岁,平均病程(19.0±3.4)d;单纯性皮肤紫癜68例,伴腹痛23例,伴关节痛17例,伴消化道出血15例;并发肾炎亚组43例,未并发肾炎亚组60例。对照组86例,男46例,平均年龄(7.0±1.1)岁。miR-374b水平:病例组(0.69±0.13)低于对照组(1.36±0.24),P<0.01;并发肾炎亚组(0.51±0.09)低于未并发肾炎亚组(0.82±0.15),P<0.01。多因素Logistic回归分析显示,过敏性紫癜患儿并发肾炎的危险因素包括:年龄≥7岁(OR=2.82,95%CI:1.94~3.93)、病程长(OR=3.50,95%CI:2.48~4.62)、伴腹痛(OR=2.62,95%CI:1.87~3.57)、伴关节痛(OR=2.59,95%CI:1.75~3.52)、伴消化道出血(OR=2.68,95%CI:1.90~3.61)、PLT高水平(OR=3.66,95%CI:2.54~4.77)、WBC高水平(OR=3.24,95%CI:2.11~4.42)、FIB高水平(OR=3.58,95%CI:2.51~4.71)、尿微量白蛋白升高(OR=3.36,95%CI:2.28~4.46)、血IgA升高(OR=3.50,95%CI:2.39~4.58)、血IgG升高(OR=3.53,95%CI:2.51~4.71)、血IgM升高(OR=3.96,95%CI:2.87~5.12)。保护因素包括:ALB高水平(OR=0.60,95%CI:0.37~0.83)、HDL高水平(OR=0.55,95%CI:0.31~0.72)和miR-374b高水平(OR=0.47,95%CI:0.14~0.65)。ROC曲线显Background Kidney injury is common in Henoch Schonlein purpura(HSP)children,and it will result in HSP nephritis.The long-term prognosis of HSP is closely related to the degree of renal involvement in children.Therefore,it is of great significance to evaluate the possibility of nephritis and give targeted intervention as soon as possible.Objective To investigate the expression level of serum miR-374 b in children with HSP and its relationship with nephritis.Design Case-control study.Methods The case group included the first-episode children with HSP and was divided into the subgroup with nephritis and the subgroup without nephritis.The control group included healthy children in physical examination.The age in both groups were≤14 years old.Peripheral venous blood(5 mL)was collected in both groups.The level of serum miR-374 b was detected by real-time fluorescence quantitative PCR.The clinical data of children in the case group were intercepted from the medical records,and the demographic data of children in the control group were obtained from the physical examination records.The influencing factors of nephritis in HSP children were analyzed.The diagnostic value of serum miR-374 b level in HSP children complicated with nephritis was analyzed by ROC curve.Main outcome measures Serum miR-374 b level.Results There were 103 cases in the case group,including 58 males,with an average age of(7.2±1.2)years and an average course of disease of(19.0±3.4)d,and there were 68 cases of simple skin purpura,23 cases with abdominal pain,17 cases with joint pain and 15 cases with gastrointestinal bleeding.There were 43 cases in the subgroup with nephritis and 60 cases in the subgroup without nephritis.There were 86 cases in the control group,including 46 males,with an average age of(7.0±1.1)years.The level of miR-374 b in the case group(0.69±0.13)was lower than that in the control group(1.36±0.24),P<0.01.The level of miR-374 b in the subgroup with nephritis(0.51±0.09)was lower than that in the subgroup without nephritis(0.82�

关 键 词：过敏性紫癜 微小RNA-374b 肾炎 评估价值 

分 类 号：R725.5[医药卫生—儿科] R726.9[医药卫生—临床医学]