紫癜性肾炎患儿血小板参数与肾脏病理分型及肾功能的关系  

Relationship of platelet parameters with renal pathological grade and renal function in children with Henoch-Schonlein purpuric nephritis

作　　者：杨扬[1] 唐帅 张建[2] YANG Yang;TANG Shuai;ZHANG Jian(School of Pediatrics,Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China;不详)

机构地区：[1]河南中医药大学儿科医学院,郑州450046 [2]河南中医药大学第一附属医院儿科

出　　处：《浙江医学》2024年第4期384-387,392,共5页Zhejiang Medical Journal

基　　金：河南省中医药科学研究专项课题(2022ZY1023)。

摘　　要：目的 探讨紫癜性肾炎(HSPN)患儿PLT、血小板压积(PCT)等血小板参数与肾脏病理分级及肾功能的关系。方法 回顾性分析2022年1月至2023年3月河南中医药大学第一附属医院收治的46例过敏性紫癜(HSP)和89例HSPN患儿的临床资料,比较两组患儿血小板参数、凝血功能、肾功能水平。HSPN患儿根据肾脏病理结果分为Ⅱ型28例、Ⅲa型32例、Ⅲb及以上29例,比较不同肾脏病理分型HSPN患儿血小板参数、凝血功能、肾功能水平、24 h尿蛋白含量(24 h UP);采用Pearson相关分析血小板参数与凝血功能、肾功能水平的关系。采用ROC曲线评价血小板参数对HSPN患儿肾功能障碍的诊断效能。结果 HSPN组PLT、PCT、尿素氮(BUN)、血肌酐(Scr)、TT水平均高于HSP组,APTT水平低于HSP组(均P<0.05)。随着肾脏病理分型的升高,PLT、PCT、BUN、24 h UP水平逐渐上升,3组间差异有统计学意义(均P<0.05)。Pearson相关分析显示,HSPN患儿PLT、PCT水平与BUN、Scr、24 h UP均呈正相关(均P<0.05)。ROC曲线分析表明,PLT、PCT两者联合诊断HSPN患儿发生肾功能障碍的AUC为0.880,高于单一指标诊断(均P<0.05),灵敏度为0.727,特异度为0.978。结论 不同肾脏病理分型HSPN患儿PLT、PCT水平存在显著差异,与肾功能指标呈显著正相关。检测HSPN患儿PLT、PCT水平有助于评估其肾脏病理分型和肾功能障碍发生情况。Objective To investigate the relationship of platelet parameters with renal pathological grade and renal function in children with Henoch-Schonlein purpura nephritis(HSPN).Methods Clinical data of 46 children with Henoch-Schonlein purpuric(HSP) and 89 children with HSPN admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2022 to March 2023 were retrospectively analyzed.The PLT,plateletcrit(PCT),urea nitrogen(BUN),serum creatinine(Scr),PT,APTT,fibrinogen(FIB),D-dimer(D-D),TT,fibrin degradation products(FDP) were compared between the two groups.According to the renal pathological results of HSPN,patients were classified as type Ⅱ(n=28),type Ⅲa(n=32),and type Ⅲb and above(n=29).The levels of PLT,PCT,BUN,Scr,FIB,D-D,FDP and 24-h urinary protein(24 h UP) were compared among different HSPN types.Pearson correlation was used to analyze the relationship of platelet parameters with BUN,Scr and 24 h UP levels.ROC curve was used to evaluate the diagnostic value of PLT and PCT for renal dysfunction in children with HSPN.Results The levels of PLT,PCT,BUN,Scr and TT in HSPN group were higher than those in HSP group,and the level of APTT was lower than that in HSP group(all P<0.05).With the aggravation of renal pathological damage,the levels of PLT,PCT,BUN and 24 h UP increased,and the differences among the three groups were statistically significant(all P<0.05).Pearson correlation analysis showed that PLT and PCT levels were positively correlated with BUN,Scr and 24 h UP(all P<0.05).ROC curve analysis showed that the AUC of PLT combined with PCT in diagnosis of renal dysfunction of children with HSPN was 0.880,which was higher than that of PLT or PCT alone(both P<0.05),with a sensitivity of 0.727 and specificity of 0.978.Conclusion There are significant differences in levels of PLT and PCT between children with HSPN and HSP,which are increased with the progress of renal pathological grades and renal dysfunction,indicating that detection of PLT and PCT levels is helpf

关 键 词：PLT 血小板压积 紫癜性肾炎 肾功能 

分 类 号：R726.9[医药卫生—儿科]