过敏性紫癜患儿血清APRIL、25(OH)D、补体C3的表达及与体液免疫的关系  

Association between serum levels of APRIL,25(OH)D and complement C3 and humoral immunity in children with Henoch-Schonlein purpura

作　　者：陈祺[1] 张贝[2] 唐长玖[1] CHEN Qi;ZHANG Bei;TANG Chang-Jiu(Department of Blood Transfusion,the Jiangxi Provincial People's Hospital,Nanchang 330006,China;Department of Gastroenterology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]江西省人民医院输血科,南昌330006 [2]南昌大学第二附属医院消化内科,南昌330006

出　　处：《现代免疫学》2022年第2期133-138,共6页Current Immunology

基　　金：江西省卫生厅课题项目(172246,20193673)。

摘　　要：为探究血清增殖诱导配体(a proliferation inducing ligand,APRIL)、25-羟基维生素D[25-hydroxyvitamin D,25(OH)D]、补体C3在过敏性紫癜(Henoch-Schonlein purpora,HSP)患儿中的表达及与体液免疫的关系,选取114例HSP患儿作为研究组,另选取110例同期健康体检儿童作为对照组。采用ELISA检测血清APRIL水平,液相色谱-串联质谱法检测血清25(OH)D水平,免疫透射比浊法检测血清IgM、IgG、IgA水平,免疫速率散射比浊法检测血清补体C3水平。结果显示,研究组血清APRIL水平明显高于对照组(P<0.001),25(OH)D、补体C3水平明显低于对照组(P<0.001)。通过ROC曲线分析,血清APRIL、25(OH)D、补体C3联合诊断HSP的AUC为0.858,大于各指标单独诊断的AUC,联合诊断的最佳敏感度为69.30%,特异度为88.18%。研究组不同疾病程度患儿间血清APRIL、25(OH)D、补体C3及IgM、IgG、IgA水平相比较,差异有统计学意义(P<0.001)。HSP患儿血清APRIL与血清IgM、IgA呈正相关(r=0.550、0.429,P=0.000),与血清IgG呈负相关(r=-0.415,P=0.000);血清25(OH)D与IgM、IgA呈负相关(r=-0.643、-0.510,P=0.000),与IgG呈正相关(r=0.575,P=0.000);补体C3与IgM、IgA呈负相关(r=-0.542、-0.548,P=0.000),与IgG呈正相关(r=0.633,P=0.000)。该研究提示,HSP患儿血清APRIL、25(OH)D、补体C3均与机体体液免疫存在良好的线性关系,且能辅助临床诊断HSP,具有较高的临床应用价值。To investigate the association between serum levels of a proliferation inducing ligand(APRIL),25-hydroxyvitamin D[25(OH)D],and complement C3 and humoral immunity in children with Henoch-Schonlein purpura(HSP),114 children with HSP were recruited as study group and 110 children undergoing regular physical examination as control group.Serum level of APRIL was detected by ELISA,25(OH)D by liquid chromatography-tandem mass spectrometry,IgM,IgG,and IgA by immunoturbidimetric assay and complement C3 by the nephelometric method.The results revealed that compared to the control group,the study group showed significantly elevated serum level of APRIL and decreased levels of 25(OH)D and complement C3(P<0.001).ROC curve analysis demonstrated that the AUC of HSP diagnosis using a panel of serum APRIL,25(OH)D and complement C3 was 0.858,higher than the AUC of using each index individually.The best sensitivity of combined diagnosis was 69.30%and the specificity was 88.18%.The serum APRIL,25(OH)D,complement C3,IgM,IgG,and IgA of children with different levels of disease severity in the study group were analyzed and found a statistically significant difference(P<0.001).There was a positive correlation between serum APRIL and serum IgM and IgA in children with HSP(r=0.550,0.429,P=0.000),and a negative correlation with serum IgG(r=-0.415,P=0.000).There was a negative correlation between serum 25(OH)D and IgM,IgA(r=-0.643,-0.510,P=0.000),but a positive correlation with IgG(r=0.575,P=0.000).There was a negative correlation between complement C3 and IgM,IgA(r=-0.542,-0.548,P=0.000),but a positive correlation with IgG(r=0.633,P=0.000).The study suggests that there is a good linear correlation between serum APRIL,25(OH)D,and complement C3 and humoral immunity in children with HSP.These indicators may also help the diagnosis of HSP,making them valuable in clinical applications.

关 键 词：过敏性紫癜 增殖诱导配体 25-羟基维生素D 补体C3 体液免疫 疾病程度 诊断 

分 类 号：R554.6[医药卫生—血液循环系统疾病]