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| 过敏性紫癜患儿25-(OH)D3、IgA/C3比值、LMR与疾病严重程度和肾脏受累的关系分析 |
| Analysis of the Relationship Between 25-(OH)D3, IgA/C3 ratio, LMR and Disease Severity and Renal Involvement in Children With Henoch-Schonlein Purpura |
| 投稿时间：2024-09-09 修订日期：2024-09-09 |
| DOI： |
| 中文关键词: 过敏性紫癜 疾病严重程度 肾脏受累 25-羟基维生素D3 免疫球蛋白A 补体C3 淋巴细胞和单核细胞比值 |
| 英文关键词: Henoch-schonlein purpura Disease severity Renal involvement 25-hydroxyvitamin D3 Immunoglobulin A Complement C3 Lymphocyte to monocyte ratio |
| 基金项目:安徽省自然科学基金项目（1908084QH497） |
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| 中文摘要: |
| 目的 分析过敏性紫癜（HSP）患儿25-羟基维生素D3[25-(OH)D3]、免疫球蛋白A（IgA）/补体C3（C3）比值、淋巴细胞和单核细胞比值（LMR）与疾病严重程度和肾脏受累的相关性。方法 选取2019年1月至2023年12月安徽医科大学附属阜阳医院儿科收治的152例HSP患儿，根据病情严重程度将患儿分为轻度组（82例）、中度组（47例）、重度组（23例）, 根据是否存在肾脏受累将患儿分为受累组（46例）和未受累组（106例）。治疗前进行实验室检查以及检测血清25-(OH)D3，计算IgA/C3比值和LMR。采用多因素Logistic回归分析影响HSP患儿肾脏受累的因素，使用受试者工作特征（ROC）分析血清25-(OH)D3、IgA/C3比值和LMR对HSP患儿肾脏受累的预测价值。结果 重度组血清25-(OH)D3、LMR低于中度组和轻度组（P＜0.05），IgA/C3比值高于中度组和轻度组（P＜0.05）。受累组血清25-(OH)D3，LMR低于未受累组（P＜0.05），IgA/C3比值高于未受累组（P＜0.05）。发病至确诊时间较长，IgA/C3比值升高是HSP患儿肾脏受累的危险因素（P＜0.05），血清25-(OH)D3升高、LMR升高是保护因素（P＜0.05）。血清25-(OH)D3、IgA/C3比值、LMR单独预测HSP患儿肾脏受累的曲线下面积（AUC）为0.771、0.729、0.773，三者联合预测的AUC为0.886，高于单独预测。结论 HSP患儿血清25-(OH)D3降低，LMR降低，IgA/C3比值升高与病情加重以及肾脏受累有关，血清25-(OH)D3、IgA/C3比值、LMR三者联合检测在预测HSP病情严重程度和肾脏受累方面具有较高价值。 |
| 英文摘要: |
| Objective To analyze the correlation between 25-hydroxyvitamin D3 [25-(OH)D3], immunoglobulin A (IgA)/complement C3 (C3) ratio, lymphocyte to monocyte ratio (LMR) and disease severity with renal involvement in the Henoch-schonlein purpura (HSP) children. Methods 152 HSP children admitted to Pediatrics of Fuyang Hospital Affiliated to Anhui Medical University from January 2019 to December 2023 were selected, the children were divided into mild group (82 cases), moderate group (47 cases) and severe group (23 cases) according to the severity of the disease, the children were divided into involved group (46 cases) and uninvolved group (106 cases) according to the presence or absence of renal involvement. Laboratory tests and serum 25-(OH)D3 were performed before treatment, and IgA/C3 ratio and LMR were calculated. Multivariate logistic regression was used to analyze the factors affecting renal involvement in children with HSP. Receiver operating characteristic (ROC) was used to analyze the predictive value of serum 25- (OH)D3, IgA/C3 ratio and LMR for renal involvement in children with HSP.Results Serum 25-(OH)D3 and LMR in severe group were lower than those in moderate group and mild group (P<0.05), and IgA/C3 ratio was higher than that in moderate group and mild group (P<0.05).The serum 25-(OH)D3 and LMR in involved group were lower than those in the uninvolved group (P<0.05), and the IgA/C3 ratio was higher than that in uninvolved group (P<0.05). The time from onset to diagnosis was longer, elevated IgA/C3 ratio was a risk factor for renal involvement in HSP children (P<0.05), elevated serum 25-(OH)D3 and elevated LMR were protective factors (P<0.05). The area under the curve ( AUC ) of serum 25-( OH )D3, IgA / C3 ratio and LMR alone in predicting renal involvement in children with HSP was 0.771, 0.729 and 0.773, respectively. The AUC of the combined prediction of the three was 0.886, which was higher than that of the single prediction. Conclusion The decrease of serum 25-(OH)D3 and LMR in HSP children, and the increase of IgA/C3 ratio are related to the aggravation of the disease and renal involvement, The combined detection of serum 25- (OH)D3, IgA/C3 ratio and LMR has high value in predicting the severity of HSP and renal involvement. |
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