慢性免疫性血小板减少症患者BLyS及其受体BAFF-R与血清免疫学指标的相关性  

Correlation analysis of BLyS and its receptor BAFF-R with serum immunological indexes in patients with chronic immune thrombocytopenia

作　　者：王婧妍 高大[1] 赵亚男[2] 陈康 闵亚楠 WANG Jingyan;GAO Da;ZHAO Yanan;CHEN Kang;MIN Yanan(The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010010,China;China-Japan Friendship Hospital,Jilin University,Changchun 130031,China;Qingdao Central Hospital,Qingdao University,Qingdao 266000,Shandong,China)

机构地区：[1]内蒙古医科大学附属医院,内蒙古呼和浩特010010 [2]吉林大学中日联谊医院,吉林长春130031 [3]青岛大学附属青岛市中心医院,山东青岛266000

出　　处：《西部医学》2024年第10期1480-1485,共6页Medical Journal of West China

基　　金：国家自然科学基金资助项目(81700110)。

摘　　要：目的探讨慢性免疫性血小板减少症(ITP)患者B淋巴细胞刺激因子(BLyS)及其受体B淋巴细胞刺激因子受体(BAFF-R)与血清免疫学指标的相关性。方法纳入内蒙古医科大学附属医院血液科2020年1月-2022年1月住院的ITP患者50例行回顾性分析,将其设为观察组,另选取同期本院体检中心接诊的50例健康体检者,将其设为对照组。检测并比较两组血清BLyS、BAFF-R、免疫学指标。将观察组患者按疾病严重程度分为轻度组(11例)、中度组(29例)、重度组(10例),比较不同严重程度组血清BLyS、BAFF-R、免疫学指标;ITP患者均给予地塞米松、丙种球蛋白、泼尼松等对症治疗,比较预后不良组、预后良好组血清BLyS、BAFF-R、免疫学指标,Pearson分析BLyS、BAFF-R与免疫学指标的相关性,绘制受试者工作曲线(ROC),计算曲线下面积(AUC),分析BLyS、BAFF-R、免疫学指标对ITP患者预后不良的预测效能。结果观察组血清BLyS、BAFF-R、外周血IgG、IgA、IgM均高于对照组(P<0.05)。重度组血清BLyS、BAFF-R、外周血IgG、IgA、IgM均高于中度组、轻度组(P<0.05)。预后不良组血清BLyS、BAFF-R、外周血IgG、IgA、IgM均高于预后良好组(P<0.05)。BLyS、BAFF-R与IgG、IgA、IgM均呈正相关性(P<0.05)(r值=4.034、3.986、4.134、3.964、4.006、4.086)。BLyS、BAFF-R、IgG、IgA、IgM联合检测预测ITP预后不良的AUC是0.801(95%CI:0.734~0.959),灵敏度、特异度分别是93.62%、90.24%,均高于单独检测(P<0.05)。结论ITP患者BLyS及其受体BAFF-R表达量随着疾病的加重会逐渐增高,与血清免疫学指标IgG、IgA、IgM均呈正相关性,联合检测可提高对预后不良的预测灵敏度及特异度,具有一定的参考价值。Objective To analyze the correlation between B lymphocyte stimulating factor(BLyS)and its receptor B lymphocyte stimulating factor receptor(AFF-R)and serum immunological indexes in patients with chronic immune thrombocytopenia(ITP).Methods Fifty cases of ITP patients admitted to the hematology department of our hospital from January 2020 to January 2022 were selected as the observation group for retrospective study,and 50 cases of healthy physical examination patients admitted to the physical examination center of our hospital during the same period were selected as the control group.Serum BLyS,AFF-R and immunological indexes of the two groups were detected and compared.Serum BLyS,AFF-R and immunological indexes were compared in different severity groups.All ITP patients were given symptomatic treatment such as dexamethasone,gamma globulin and prednisone.Serum BLyS,AFF-R and immunological indexes were compared between the poor prognosis group and the good prognosis group.The correlation between BLyS,AFF-R and immunological indexes was analyzed by Pearson,receiver operating curve(ROC)was drawn,and area under the curve(AUC)was calculated.To analyze the predictive efficacy of BLyS,AFF-R and immunological indexes for poor prognosis in patients with ITP.Results Serum BLyS,AFF-R,peripheral blood IgG,IgA and IgM in observation group were higher than those in control group(P<0.05).Serum BLyS,AFF-R,peripheral blood IgG,IgA and IgM in severe group were higher than those in moderate and mild groups(P<0.05).Serum BLyS,AFF-R,peripheral blood IgG,IgA and IgM in poor prognosis group were higher than those in good prognosis group(P<0.05).BLyS,AFF-R were positively correlated with IgG,IgA and IgM(P<0.05)(r=4.034,3.986,4.134,3.964,4.006,4.086).The AUC of BLyS,AFF-R,IgG,IgA and IgM in predicting poor prognosis of ITP was 0.801(95%CI:0.734-0.959),and the sensitivity and specificity were 93.62%and 90.24%,respectively,higher than that of single detection(P<0.05).Conclusion The expression levels of BLyS and its receptor AFF-R in ITP pa

关 键 词：慢性免疫性血小板减少症 B淋巴细胞刺激因子 B淋巴细胞刺激因子受体 免疫学指标 

分 类 号：R558.2[医药卫生—血液循环系统疾病]