过敏性紫癜患儿外周血25-(OH)D_(3)、CD4^(+)/CD8^(+)、免疫球蛋白水平与疾病复发的关系研究  

Study on the relationship between the levels of 25-(OH)D_(3),CD4^(+)/CD8^(+)and immunoglobulins in peripheral blood and disease recurrence in children with Henoch-Schonlein purpura

作　　者：张林[1] 朱国琴 葛婷婷[1] 赵丽萍[1] ZHANG Lin;ZHU Guoqin;GE Tingting;ZHAO Liping(Department of Intrarenal Rheumatology and Immunology,Wuxi Children's Hospital,Jiangsu Wuxi 214023,China)

机构地区：[1]无锡市儿童医院肾内风湿免疫科,江苏无锡214023

出　　处：《中国妇幼健康研究》2023年第9期7-12,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨过敏性紫癜(HSP)患儿外周血25-羟基维生素D_(3)[25-(OH)D_(3)]、白细胞分化抗原4/白细胞分化抗原8(CD4^(+)/CD8^(+))、免疫球蛋白水平(IgA、IgG)与疾病复发的关系。方法选取2019年5月至2022年4月无锡市儿童医院收治的100例HSP患儿为研究对象,根据患儿病情严重程度分为轻度组(n=43)、中度组(n=32)和重度组(n=25),比较三组外周血25-(OH)D_(3)、CD4^(+)/CD8^(+)、免疫球蛋白水平;随访6个月后,采用多因素Logistic回归分析25-(OH)D_(3)、CD4^(+)/CD8^(+)、免疫球蛋白与疾病复发的关系。结果重度组外周血IgA水平高于轻度组和中度组,25-(OH)D_(3)、CD4^(+)/CD8^(+)、IgG水平低于轻度组和中度组,差异具有统计学意义(F值介于9.127~24.936之间,P<0.05);随访6个月后,复发组外周血IgA水平高于未复发组,25-(OH)D_(3)、CD4^(+)/CD8^(+)、IgG水平低于未复发组,差异具有统计学意义(t值介于2.464~3.435之间,P<0.05);25-(OH)D_(3)、CD4^(+)/CD8^(+)、IgA、IgG联合预测HSP患儿疾病复发的曲线下面积(AUC)为0.853,高于单一指标检测(Z值介于2.033~3.487之间,P<0.05);多因素Logistic回归分析显示,外周血25-(OH)D_(3)≤19.81ng/mL、CD4^(+)/CD8^(+)≤0.86、IgA>1.98g/L均为HSP患儿疾病复发的独立危险因素,其OR值及95%CI分别为11.936(3.343~42.619)、4.554(1.261~16.443)、7.869(2.086~29.674)。结论HSP患儿外周血25-(OH)D_(3)、CD4^(+)/CD8^(+)、IgA、IgG与病情严重程度相关,四者联合对疾病复发具有较高的预测价值。Objective To explore the relationship between levels of 25-hydroxyvitamin D_(3)[25-(OH)D_(3)]leukocyte differentiation antigen 4/leukocyte differentiation antigen 8(CD4^(+)/CD8^(+)),immunoglobulins(IgA,IgG)and disease recurrence in peripheral blood of children with Henoch-Schonlein purpura(HSP).Methods A total of 1oo children with HSP who treated in Wuxi Children's Hospital from May 2019 to April 2022 were selected as research objects.They were divided into the mild group(n=43),the moderate group(n=32)and the severe group(n=25)according to the severity of the disease.The levels of peripheral blood 25-(OH)Ds,CD4^(+)/CD8^(+)and immunoglobulins in the three groups were compared.After 6 months of follow-up,multivariate Logistic regression was used to analyze the relationship between 25-(OH)D_(3),CD4^(+)/CD8^(+),immunoglobulin and disease recurrence.Results The levels of IgA in peripheral blood of severe group were higher than those in mild and moderate groups,and the levels of 25-(OH)Ds,CD4^(+)/CD8^(+)and IgG were lower than those of mild and moderate groups,and the difference was statistically significant(F value ranged from 9.127 to 24.936,P<0.05).After 6 months of follow-up,the level of peripheral blood IgA in recurrence group was higher than that in non-recurrence group,while the levels of 25-(OH)D_(3),CD4^(+)/CD8^(+)and IgG were lower than those in non-recurrence group,and the difference was statistically significant(t value ranged from 2.464 to 3.435,P<0.05).The area under the curve(AUC)of 25-(OH)Ds,CD4^(+)/CD8^(+),IgA and IgG combined to predict disease recurrence in children with HSP was 0.853,which was higher than that of single index detection(Z value ranged from 2.033 to 3.487,P<0.05).Multivariate Logistic regression analysis showed that peripheral blood 25-(OH)D,≤19.81 ng/mL,CD4^(+)/CD8^(+)≤0.86 and IgA>1.98 g/L were independent risk factors for disease recurrence in HSP children.The OR value and 95%CI were 11.936(3.343-42.619),4.554(1.261-16.443),and 7.869(2.086-29.674),respectively.Conclusion 25-(OH

关 键 词：过敏性紫癜 25-羟基维生素D_(3) 免疫球蛋白 疾病复发 

分 类 号：R179[医药卫生—妇幼卫生保健]