紫癜性肾炎患儿血清LRG1和CCL19水平检测对临床早期诊断及预后的价值研究  

Value of Serum LRG1 and CCL19 Levels Detection in Early Clinical Diagnosis and Prognosis of Children with Purpura Nephritis

作　　者：郭玉敏 石艳沙 李然 路冲 陈文华 GUO Yumin;SHI Yansha;LI Ran;LU Chong;CHEN Wenhua(Handan Central Hospital,Hebei Handan 056008,China)

机构地区：[1]邯郸市中心医院,河北邯郸056008

出　　处：《现代检验医学杂志》2024年第5期157-161,共5页Journal of Modern Laboratory Medicine

基　　金：邯郸市科学技术研究与发展计划项目任务合同(21422083034)。

摘　　要：目的探究紫癜性肾炎(henoch-schonlein purpura nephritis,HSPN)患儿血清富亮氨酸α2糖蛋白1(leucinerich-alpha-2-glycoprotein1,LRG1)和趋化因子(C-C基序)配体19(CC chemokine ligand 19,CCL19)水平检测对临床早期诊断及预后的价值研究。方法选取2021年5月~2023年5月于邯郸市中心医院就诊治疗的108例HSPN患儿作为研究对象,同时选取72例体检健康儿童作为对照组。检测两组血清LRG1,CCL19,IgM,IgA及IgG水平。利用Logistic回归方法分析HSPN发生的影响因素,ROC曲线评估LRG1,CCL19水平对HSPN患儿早期诊断临床价值。分析处于HSPN急性期、慢性期、康复期患儿血清LRG1,CCL19水平差异,利用Spearman相关性分析探究血清LRG1,CCL19水平与HSPN患儿病程时期的关联。结果HSPN组患儿血清LRG1(184.36±23.64 ng/L),CCL19(463.19±89.46 ng/L)水平均显著高于对照组儿童(149.42±18.29 ng/L,208.83±52.97 ng/L),差异具有统计学意义(t=10.600,21.710,均P<0.05)。Logistic回归结果显示,LRG1[OR(95%CI):1.429(1.057~1.933)],CCL19[OR(95%CI):1.842(1.216~2.791)]均是儿童发生HSPN的影响因素(均P<0.05)。受试者工作特征(ROC)曲线分析可知,血清LRG1,CCL19及二者联合诊断儿童发生HSPN的曲线下面积(AUC)分别为0.868,0.881和0.952,且二者联合应用于临床诊断预测患儿发生HSPN优于血清LRG1,CCL19各自单独诊断(Z=3.147,3.487,均P=0.001)。HSPN急性期、慢性期患儿血清LRG1(203.49±24.89 ng/L,177.56±23.19 ng/L),CCL19(591.13±98.32ng/L,415.61±89.82 ng/L)水平显著高于康复期患儿(158.53±21.96 ng/L,295.17±69.61 ng/L),差异具有统计学意义(t=6.917,12.101;5.320,3.102,均P<0.05),HSPN急性期患儿血清LRG1,CCL19水平明显高于慢性期患儿,差异具有统计学意义(t=5.059,8.750,均P<0.05)。Spearman相关性分析显示,HSPN患儿血清LRG1,CCL19水平与其病程时期均呈正相关(r=0.506,0.689,均P<0.001)。结论HSPN患儿血清LRG1,CCL19水平升高,二者联合检测可提高HSPN的早期临床诊断价值,评估HSPN�Objective To explore the value of serum leucine-rich-alpha-2-glycoprotein-1(LRG1)and CC motif chemokine ligand 19(CCL19)detecting levels in children with henoch-schonlein purpura nephritis(HSPN)for early clinical diagnosis and prognosis.Methods A sum of 108 children with HSPN who were treated at Handan Central Hospital from May 2021 to May 2023 were selected as the study subjects,meantime,72 healthy children were as the control group.The levels of LRG1,CCL19,IgM,IgA,and IgG in serum were detected.Logistic regression method was applied to analyze the influencing factors of HSPN,receiver operating characteristic was applied to evaluate the clinical value of LRG1 and CCL19 levels for early diagnosis of HSPN in children.The differences in serum LRG1 and CCL19 levels among children with HSPN in the acute,chronic,and recovery stages were analyzed,Spearman correlation was applied to analyze and explore the correlation between serum LRG1,CCL19 levels and the duration of HSPN in children.Results The levels of LRG1(184.36±23.64 ng/L)and CCL19(463.19±89.46 ng/L)in the HSPN group were obviously higher than those in the control group(149.42±18.29 ng/L,208.83±52.97 ng/L),and the differences were significant(t=10.600,21.710,all P<0.05).The Logistic regression results showed that LRG1[OR(95%CI):1.429(1.057~1.933)]and CCL19[OR(95%CI):1.842(1.216~2.791)]were both influencing factors for the occurrence of HSPN in children(P<0.05).According to the analysis of receiver operating characteristic(ROC),the areas under the curve(AUC)of serum LRG1,CCL19 and their combined diagnosis of HSPN in children were 0.868,0.881 and 0.952,respectively,and their combined application in clinical diagnosis was better than that of serum LRG1 and CCL19 in their separate diagnosis(Z=3.147,3.487,all P=0.001).The levels of LRG1(203.49±24.89 ng/L,177.56±23.19 ng/L)and CCL19(591.13±98.32 ng/L,415.61±89.82 ng/L)in the serum of HSPN patients in the acute and chronic stages were obviously higher than those in the rehabilitation stage(158.53±21.96 ng/L,29

关 键 词：紫癜性肾炎 富亮氨酸α2糖蛋白1 趋化因子(C-C基序)配体19 

分 类 号：R692.34[医药卫生—泌尿科学] R392.11[医药卫生—外科学]