外周血Hcy、CD28、CD152水平对儿童中枢神经系统血管炎的诊断及预后评估中的价值  

The value of peripheral blood Hcy,CD28 and CD152 levels in the diagnosis and prognostic assessment of central nervous system vasculitis in children

作　　者：门欣怡[1] 王蕾 季辉[2] 王秀霞[1] 田晓瑜[1] 张祥建[2] MEN Xinyi;WANG Lei;JI Hui;WANG Xiuxia;TIAN Xiaoyu;ZHANG Xiangjian(Department of Pediatrics,the Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China;Department of Neurology,the Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北医科大学第二医院儿科,河北石家庄050000 [2]河北医科大学第二医院神经内科,河北石家庄050000

出　　处：《国际检验医学杂志》2023年第22期2700-2705,共6页International Journal of Laboratory Medicine

基　　金：河北省卫生厅项目(20180294)。

摘　　要：目的探讨外周血同型半胱氨酸(Hcy)、CD28、CD152水平对儿童中枢神经系统血管炎(CNSV)的诊断及预后评估中的应用价值,为早期诊断及预后预测提供参考。方法选取2019年1月至2022年1月该院60例CNSV患儿作为观察组,观察组予以免疫治疗,治疗6个月。另选取同期体检健康者60例作为对照组。检测观察组入院时、对照组体检时外周血指标水平及观察组治疗1个月、3个月及6个月后外周血指标水平,分析其对儿童CNSV的诊断价值及复发的影响因素,并分析外周血Hcy与CD28、CD152交互效应对儿童CNSV复发的影响。结果入组后观察组外周血Hcy、CD28、CD152水平均高于对照组,联合诊断儿童CNSV的曲线下面积为0.912,较单独指标高,差异有统计学意义(P<0.05);复发患儿疾病分期为活动期比例及治疗6个月后外周血Hcy、CD28、CD152水平均高于未复发患儿,差异有统计学意义(P<0.05);疾病分期、治疗6个月后外周血Hcy、CD28、CD152均为儿童CNSV复发的独立危险因素(P<0.05);治疗6个月后Hcy与CD28、Hcy与CD152间无相乘交互效应(P>0.05);治疗6个月后Hcy与CD28、治疗6个月后Hcy与CD152同时暴露时复发风险分别是非暴露的6.535、6.171倍。结论外周血Hcy、CD28、CD152对儿童CNSV有较高诊断价值,且均为复发的独立危险因素,治疗6个月后Hcy与CD28、Hcy与CD152同时暴露可增加儿童CNSV复发的危险性,存在相加交互效应。Objective To investigate the application value of peripheral blood homocysteine(Hcy),CD28,CD152 levels in the diagnosis and prognosis of children with central nervous system vasculitis(CNSV),and to provide reference for early diagnosis and prognosis prediction.Methods Sixty cases of children with CNSV in the Second Hospital of Hebei Medical University,Shijiazhuang from January 2019 to January 2022 were selected as the observation group,and another 60 cases of healthy physical examination patients in the same period were selected as the control group,and the observation group was given immunotherapy and treated for 6 months.The peripheral blood index levels at the time of admission of the observation group,at the time of physical examination of the control group and the peripheral blood index levels at 1 month,3 months and 6 months of treatment of the observation group were tested to analyse their diagnostic value and the factors affecting the recurrence of CNSV in children,and to analyse the effect of the interaction of peripheral blood Hcy with CD28 and CD152 on the recurrence of CNSV in children.Results The levels of peripheral blood Hcy,CD28 and CD152 were higher in the observation group than in the control group after enrolment,and the area under curve for the combined diagnosis of CNSV in children was 0.912,which was higher than the index alone,and the difference was statistically significant.(P<0.05);The proportion of patients with recurrence with active stage and the levels of Hcy,CD28 and CD152 in peripheral blood after 6 months of treatment were higher than those without recurrence,and the difference was statistically significant(P<0.05).Disease stage,peripheral blood Hcy,CD28,CD152 after 6 months of treatment were independent risk factors for CNSV recurrence in children(P<0.05).After 6 months of treatment,Hcy and C D28 and Hcy and CD152 had no multiplicative interaction effect(P>0.05).The recurrence risk of Hcy and CD28 and Hcy and CD152 at the same time after 6 months of treatment was 6.535 times and 6

关 键 词：中枢神经系统血管炎 同型半胱氨酸 CD28 CD152 交互效应 

分 类 号：R743[医药卫生—神经病学与精神病学]