Value of lymphocyte subsets combined with immunoglobulin for diagnosis of Henoch-Schonlein purpura complicated by gastrointestinal symptoms in children
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摘要: 目的 探究淋巴细胞亚群联合免疫球蛋白(Ig)对儿童过敏性紫癜并发胃肠道症状的诊断价值。方法 回顾性分析2017年12月—2022年12月在医院就诊的80例过敏性紫癜患儿的临床资料，并根据患儿过敏性紫癜症状分为并发组和单纯组，将患有过敏性紫癜并发胃肠道症状的40例患儿设为并发组，仅有以皮肤紫癜为首发症状的40例单纯性紫癜患儿设为单纯组。比较2组一般资料、淋巴细胞亚群、免疫球蛋白，并采用Spearman法比较自然杀伤(NK)细胞计数及IgA、IgE、IgG水平与患儿过敏性紫癜并发胃肠道症状的相关性。结果 并发组NK细胞计数及IgA、IgG水平明显低于单纯组(P < 0.05)，IgE水平明显高于单纯组(P < 0.05)，NK细胞计数及IgA、IgG水平与过敏性紫癜并发胃肠道症状呈负相关(P < 0.05)，IgE水平与过敏性紫癜并发胃肠道症状呈正相关(P < 0.05)，NK细胞计数及IgA、IgE、IgG水平诊断儿童过敏性紫癜并发胃肠道症状的AUC值分别为0.649、0.644、0.829、0.969(P < 0.05)。结论 淋巴细胞亚群联合免疫球蛋白对儿童过敏性紫癜并发胃肠道症状可能有较好的诊断价值，NK细胞计数及IgA、IgG水平下降、IgE水平上升可能提示患儿过敏性紫癜并发胃肠道症状。Abstract: Objective To explore the diagnostic value of lymphocyte subsets combined with immunoglobulin(Ig) in children with Henoch-Schonlein purpura complicated with gastrointestinal symptoms.Methods The clinical data of 80 children with Henoch-Schonlein purpura treated in our hospital from December 2017 to December 2022 were retrospectively analyzed. According to the symptoms of Henoch-Schonlein purpura, the children were divided into a complicated group and a simple group. 40 children with Henoch-Schonlein purpura complicated with gastrointestinal symptoms were assigned as the complicated group. Only 40 cases of pure purpura with skin purpura as the first symptom were set as the simple group. The general data, lymphocyte subsets, immunoglobulin were compared between the two groups, and the correlation between natural killer(NK) cell count, IgA, IgE, IgG levels and gastrointestinal symptoms of children with Henoch-Schonlein purpura was compared by Spearman method.Results The NK cell count, IgA and IgG levels in the complicated group were significantly lower than those in the simple group(P < 0.05), and the IgE level was significantly higher than that in the simple group(P < 0.05). The NK cell count, IgA and IgG levels were negatively correlated with the gastrointestinal symptoms of Henoch-Schonlein purpura(P < 0.05). IgE level was positively correlated with Henoch-Schonlein purpura complicated with gastrointestinal symptoms(P < 0.05). The AUC values of NK cell count, IgA, IgE and IgG levels in the diagnosis of Henoch-Schonlein purpura complicated with gastrointestinal symptoms in children were 0.649, 0.644, 0.829 and 0.969, respectively(P < 0.05).Conclusion Lymphocyte subsets combined with immunoglobulin may have a good diagnostic value for children with Henoch-Schonlein purpura complicated with gastrointestinal symptoms. The decrease of NK cell count, IgA and IgG levels, and the increase of IgE level may indicate children with henoch-Schonlein purpura complicated with gastrointestinal symptoms.
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Key words:
- children /
- henoch-schonlein purpura /
- lymphocyte subsets /
- immune globulin /
- gastrointestinal symptom
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表 1 2组一般资料比较
组别 单纯组(n=40) 并发组(n=40) t/χ2 P 性别/例 0.450 0.502 男 18 21 女 22 19 年龄/岁 6.15± 1.67 6.48± 1.75 0.848 0.399 发病季节/例 0.687 0.876 春季 9 7 夏季 7 6 秋季 13 13 冬季 11 14 发病原因/例 1.340 0.855 呼吸道感染 16 15 尿路感染 8 11 海鲜类过敏 6 7 支气管炎 6 5 蚊虫叮咬 4 2 严重紫癜/例 0.051 0.822 是 18 17 否 22 23 紫癜分布/例 0.497 0.780 四肢伸侧 13 15 下肢 16 13 臀部 11 12 消化道症状分布/例 0.421 0.810 腹痛 9 10 便血 6 4 胃肠道出血 1 1 
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表 2 各指标的相关性分析
指标 r P NK细胞计数 -0.256 0.011 IgA -0.232 0.019 IgE 0.581 < 0.001 IgG -0.794 < 0.001
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表 3 各指标诊断儿童过敏性紫癜并发胃肠道症状的ROC曲线分析
指标 AUC 灵敏度 特异度 最佳截断值 P NK细胞计数 0.649 0.975 0.325 14.600% 0.021 IgA 0.644 0.725 0.650 2.010 g/L 0.027 IgE 0.829 0.675 0.900 272.485 IU/mL < 0.001 IgG 0.969 0.950 0.925 10.060 g/L < 0.001
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