摘要
目的 探索血清胰岛素样生长因子结合蛋白-3(IGFBP-3)及半乳糖缺乏免疫球蛋白A1(Gd-IgA1)联合检测在儿童紫癜性肾炎(HSPN)早期诊断中的应用价值。方法 选取2021年6月至2023年4月在该院确诊的105例首发过敏性紫癜(HSP)患儿作为研究对象,在入院后按照HSP是否累及肾脏将患儿分为HSPN组及无肾炎组(HSP组),同期选择在该院体检的52例健康儿童作为对照组(NC组)。收集3组临床资料,采用酶联免疫吸附试验(ELISA)对血清及尿液中IGFBP-3、Gd-IgA1表达水平进行检测,受试者工作特征(ROC)曲线分析血清IGFBP-3、Gd-IgA1对HSPN的早期诊断价值,多因素Logistic回归分析HSPN早期发生的影响因素。结果 与NC组相比,HSPN组及HSP组的IgA、IgG、补体C3、IgA/C3、白细胞计数(WBC)、红细胞计数(RBC)、血小板计数(PLT)及血清光抑素C(CysC)、血肌酐(sCr)水平显著升高(P<0.05),但HSPN组与HSP组的临床资料差异无统计学意义(P>0.05);HSPN组及HSP组血清IGFBP-3、Gd-IgA1及尿液IGFBP-3/尿肌酐(uCr)、Gd-IgA1/uCr表达水平较NC组显著升高(P<0.05),并且,与HSP组相比,HSPN组血清IGFBP-3、Gd-IgA1及尿液Gd-IgA1/uCr表达水平进一步升高(P<0.05);ROC曲线分析显示,联合IGFBP-3、Gd-IgA1诊断HSPN的曲线下面积(AUC)显著大于IGFBP-3单独诊断的AUC(Z=3.629,P<0.001)和Gd-IgA1单独诊断的AUC(Z=2.274,P=0.023);多因素Logistic回归分析显示,血清CysC、IGFBP-3、Gd-IgA1、尿液Gd-IgA1/uCr是HSPN早期发生的影响因素(P<0.05)。结论 HSPN患儿血清IGFBP-3、Gd-IgA1的表达水平均显著上升,二者是HSPN早期发生的影响因素,血清IGFBP-3、Gd-IgA1水平联合检测对HSPN的早期诊断具有较高的应用价值。
Objective To explore the value of combined detection of serum insulin-like growth factor binding protein-3(IGFBP-3)and galactose deficiency IgA1(Gd-IgA1)in the early diagnosis of Henoch Schonlein purpura nephritis(HSPN)in children.Methods A total of 105 children with first-episode allergic purpura(HSP)diagnosed in the hospital from June 2021 to April 2023 were collected as the study subjects,after admission,the children were grouped into HSPN group and non nephritis group(HSP group)based on whether the kidneys were involved,and 52 healthy children who underwent physical examination in the hospital were regarded as the control group(NC group)during the same period.The clinical data of three groups were collected.ELISA method was applied to detect the expression levels of IGFBP-3 and Gd-IgA1 in serum and urine.Receiver operating characteristic(ROC)curve was applied to analyze the early diagnostic value of serum IGFBP-3 and Gd-IgA1 for HSPN.Multivariate Logistic regression was applied to analyze the influencing factors of early occurrence of HSPN.Results Compared with the NC group,the levels of IgA,IgG,complement C3,IgA/C3,white blood cells(WBC),red blood cells(RBC),blood platelet count(PLT),serum CysC,and serum creatinine(sCr)in the HSPN and HSP groups were obviously increased(P<0.05),however,there was no obvious difference in clinical data between the HSPN group and the HSP group(P>0.05).The expression levels of serum IGFBP-3,Gd-IgA1,and urine IGFBP-3/urine creatinine(uCr),Gd-IgA1/uCr in the HSPN and HSP groups were obviously higher than those in the NC group(P<0.05).Compared with the HSP group,the expression levels of serum IGFBP-3,Gd-IgA1,and urine Gd-IgA1/uCr in the HSPN group were further increased(P<0.05);the ROC curve analysis showed that the area under the curve(AUC)of combined IGFBP-3 and Gd-IgA1 diagnosis of HSPN was significantly greater than that of IGFBP-3 diagnosis alone(Z=3.629,P<0.001)and that of Gd-IgA1 diagnosis alone(Z=2.274,P=0.023).Multivariate Logistic regression analysis showed that serum CysC,IGFBP-3,Gd IgA1,and urine Gd IgA1/uCr were the influencing factors for the early occurrence of HSPN(P<0.05).Conclusion The expression levels of serum IGFBP-3 and Gd-IgA1 in children with HSPN are obviously increased,which are influencing factors for the early occurrence of HSPN.Combined detection of serum IGFBP-3 and Gd-IgA1 levels has practical value for the early diagnosis of HSPN.
作者
吴丽敏
张海燕
WU Limin;ZHANG Haiyan(Department of Pediatrics,Xiaogan Central Hospital,Xiaogan,Hubei 432000,China)
出处
《国际检验医学杂志》
CAS
2024年第8期950-954,共5页
International Journal of Laboratory Medicine
基金
2021年度孝感市自然科学计划项目(XGKJ2021010098)。
