过敏性紫癫患儿外周血单个核细胞中ASC mRNA和NLRP3 mRNA表达水平及其与并发肾炎的关系  

Expression levels of ASC mRNA and NLRP3 mRNA in peripheral blood monocytes of children with HSP and their relationships with complication of HSP nephritis

作　　者：付中英 杨燕玲[1] 苏月华 于晗澍[1] 李曼 朱凤芹 常红[3] FU Zhongying;YANG Yanling;SU Yuehua;YU Hanshu;LI Man;ZHU Fengqin;CHANG Hong(Department of Pediatrics,Heze Municipal Hospital,Shandong Heze 274000,China;Physical Examination Center of Heze Municipal Hospital,Shandong Heze 274000,China;Department of Pediatrics,The Af filiated Hospital of Qingdao University,Shandong Qingdao 266000,China)

机构地区：[1]菏泽市立医院儿科,山东菏泽274000 [2]菏泽市立医院体检中心,山东菏泽274000 [3]青岛大学附属医院儿科,山东青岛266000

出　　处：《中国妇幼健康研究》2024年第11期20-31,共12页Chinese Journal of Woman and Child Health Research

基　　金：山东省高等学校科技计划项目(J17KB084)。

摘　　要：目的探讨过敏性紫癫(HSP)患儿外周血单个核细胞中炎性体凋亡相关斑点样蛋白(ASC)mRNA和核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)mRNA表达水平及其与并发肾炎的关系。方法选择2020年7月至2022年12月于菏泽市立医院就诊的76例HSP患儿为观察组,收集其临床资料;以同期在院体检的48例健康儿童为对照组。根据患儿是否并发肾炎,将观察组分为过敏性紫癜肾炎(HSPN)组22例与HSP组54例。比较观察组与对照组、HSPN组和HSP组及对照组的临床资料,采用Logistic回归模型分析HSP患儿并发肾炎的危险因素,采用限制性立方样条模型分析ASC mRNA和NLRP3 mRNA与HSP患儿并发肾炎的关系。利用y=1-1/(1+e-z)回归方程建立HSP患儿并发肾炎的预测模型,以十字交叉验证法验证模型的稳定性。结果观察组与对照组的体质量指数(BMI)、白细胞(WBC)、血小板(PLT)、红细胞(RBC)、中性粒细胞(NEU)、C反应蛋白(CRP)、甘油三酯(TG)、血清肌酐(Scr)、尿素氮(BUN)、尿微量白蛋白(mALB)、纤维蛋白原(FIB)、纤维蛋白原降解产物(FDP)、D-二聚体(D-D)、低密度脂蛋白胆固醇(LDL-C)、免疫球蛋白(Ig)A、IgG、IgM、白细胞介素(IL)-16、IL-18、胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)、胱抑素(CysC)、肿瘤标志物(TM)、血管性血友病因子(vWF)、血管细胞间黏附分子-Ⅰ(sVCAM-Ⅰ)、结缔组织生长因子(CTGF)、基质金属蛋白酶9(MMP9)、ASC mRNA、NLRP3 mRNA比较,差异均有统计学意义(t=2.587~22.473,P<0.05)。调整相关混杂因素后,按照总HSP切点将ASC mRNA转化为二分类变量后,与低ASC mRNA表达水平比较,高ASC mRNA表达水平与HSP有关联(OR=0.723,95%CI:0.672~0.831,P<0.001);按照总HSP切点将NLRP3 mRNA转化为二分类变量后,与低NLRP3 mRNA表达水平比较,高NLRP3 mRNA表达水平与HSP有关联(OR=0.642,95%CI:0.611~0.791,P<0.001)。HSPN组、HSP组和对照组的BMI、WBC、PLT、RBC、NEU、CRP�Objective To investigate expression levels of inflammasome apoptosis-associated speck-like caspases(ASC)mRNA and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)mRNA in peripheral blood monocytes of children with allergic purpura[Hen ch-Sch enlein purpura(HSP)]and their relationships with HSP complicated nephritis(HSPN).Methods 76 children with HSP who were treated in Heze Municipal Hospital from July 2020 to December 2022 were included in observation group.48 healthy children who underwent physical examination in the hospital during the same period were selected as control group.According to whether the child had HSP complicated nephritis,the children in the observation group were divided into HSPN group(n=22)and HSP group(n=54).The clinical data of the children in HSPN group,HSP group and the control group were collected,analyzed and compared.Logistic regression model was used to analyze risk factors of complication of HSPN in the children with HSP.Restricted cubic spline(RCS)model was used to analyze correlations of ASC mRNA and NLRP3 mRNA with HSPN.The prediction model of HSPN was established by using y=1-1/(1+e-z)regression equation,and stability of the model was verified by cross-validation method.Results There were significant differences in body mass index(BMI),white blood cell count(WBC),platelet count(PLT),red blood cell count(RBC),neutrophilic granulocyte count(NEU),C-reactive protein(CRP),triglyceride(TG),serum creatinine(Scr),blood urea nitrogen(BUN),micro-albumin(mALB),fibrinogen(FIB),fibrinogen degradation products(FDP),D-dimer(D-D),low density lipoprotein cholesterol(LDL-C),immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),interleukin-16(IL-16),interleukin-18(IL-18),insulin-like growth factors-1(IGF-1),insulin-like growth factor binding protein-3(IGFBP-3),cystatin C(CysC),tumor marker(TM),von Willebrand factor(vWF),vascular intercellular adhesion molecule-Ⅰ(sVCAM-Ⅰ),connective tissue growth factor(CTGF),metalloproteinase 9(MMP9),ASC mRNA and NLRP3 mRNA o

关 键 词：过敏性紫癫 过敏性紫癜肾炎 凋亡相关斑点样蛋白 核苷酸结合寡聚化结构域样受体蛋白3 患儿 

分 类 号：R179[医药卫生—妇幼卫生保健]