颗粒蛋白前体在儿童免疫性血小板减少症中的应用价值  

Application value of progranulin in children with immune thrombocytopenia

作　　者：石磊 景春梅[1] 刘茜[1] 王偲[1] SHI Lei;JING Chunmei;LIU Qian;WANG Cai(Department of Laboratory,Children′s Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disease/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院检验科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室,重庆400014

出　　处：《现代医药卫生》2023年第21期3661-3664,3668,共5页Journal of Modern Medicine & Health

基　　金：重庆市科卫联合中医药科研项目(2019ZY3206)。

摘　　要：目的探讨颗粒蛋白前体(PGRN)在儿童免疫性血小板减少症(ITP)中的应用价值。方法选取2021年7月至2022年12月该院收治的儿童ITP患儿60例(ITP组)、再生障碍性贫血(AA)患儿45例(AA组),以及健康儿童45例(健康对照组)作为研究对象,采用血细胞分析仪检测3组研究对象血小板计数及平均血小板体积,采用酶联免疫吸附法测定3组研究对象血清PGRN水平,且比较其血清PGRN水平的差异。采用受试者工作特征曲线分析检测PGRN对ITP、AA的鉴别诊断价值。结果ITP组和AA组患儿血小板计数均明显低于健康对照组,ITP组患儿PGRN水平明显高于健康对照组及AA组,差异均有统计学意义(P<0.05)。ITP组患儿经静脉注射免疫球蛋白治疗后PGRN下降。当PGRN临界值为71.85 ng/mL时鉴别诊断ITP与健康儿童的ROC曲线下面积为0.903,灵敏度为66.7%,特异度为97.8%;当PGRN临界值为86.45 ng/mL时鉴别诊断ITP与AA的ROC曲线下面积为0.826,灵敏度为53.3%,特异度为97.8%。结论ITP组患儿血清PGRN水平升高,且可作为与AA鉴别诊断的一个较好指标。Objective To investigate the clinical value of granule protein precursor(PGRN)in children with immune thrombocytopenia(ITP).Methods 60 children with ITP(ITP group),45 children with aplastic anemia(AA group)and 45 healthy children(healthy control group)admitted to the hospital from July 2021 to December 2022 were selected as the research objects.The blood cell analyzer was used to detect the platelet count and average platelet volume of the three groups of subjects.The serum PGRN The serum PGRN level of the three groups of subjects was determined by enzyme-linked immunosorbent assay,and the difference of serum PGRN level was compared.Receiver operating characteristic(ROC)curve analysis was used to detect the value of PGRN in the differential diagnosis of ITP and AA.Results Compared with the healthy control group,the ITP and AA groups had a significantly lower platelet count and a significantly higher level of PGRN,with statistically significant differences(P<0.05).PGRN decreased in children with ITP after intravenous immunoglobulin(IVIG)treatment.When the cut-off value of PGRN was 71.85 ng/mL,the area under the ROC curve of ITP and healthy children was 0.903,the sensitivity was 66.7%,and the specificity was 97.8%.When the cut-off value of PGRN was 86.45 ng/mL,the area under the ROC curve for the differential diagnosis of ITP and AA was 0.826,the sensitivity was 53.3%,and the specificity was 97.8%.Conclusion The serum level of PGRN is increased in children with ITP group and it can be used as a good indicator for the differential diagnosis with AA.

关 键 词：免疫性血小板减少症 儿童 颗粒蛋白前体 鉴别诊断 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R446.1[医药卫生—内科学]