过敏性紫癜患儿IgA D-D FDP水平与疾病复发的关系

Relationship between Levels of IgA,D-Dimer,and Fibrinogen Degradation Products and Disease Recurrence in Children with Henoch-Schonlein Purpura

目的:探讨免疫球蛋白A(IgA)、D-二聚体(D-D)、纤维蛋白降解产物(FDP)水平与过敏性紫癜(HSP)患儿疾病复发的关系。方法:选取2022年11月至2023年4月在我院收治的160例HSP患儿为研究对象,采用全自动生化分析仪检测IgA水平;全自动血凝仪测定D-D、FDP水平。随访6个月,根据随访结果,分为复发组(n=34)和未复发组(n=136)。比较两组IgA、D-D、FDP水平,采用受试者工作曲线(ROC)、曲线下面积(AUC)分析各指标对疾病复发的预测价值;采用多因素Logistic回归分析各指标对疾病复发的影响。结果:复发组患儿IgA[3.305(2.565,4.402)g/L]、D-D[1.470(0.477,2.742)μg/mL]、FDP[4.445(2.442,9.212)μg/mL]水平均高于未复发组IgA[2.360(1.697,3.012)g/L]、D-D[0.310(0.200,0.575)μg/mL]、FDP[1.920(1.140,2.890)μg/mL],差异具有统计学意义(P<0.05)。ROC曲线分析显示,IgA、D-D、FDP三者联合预测HSP患儿疾病复发的AUC为0.892,高于单一检测指标,敏感度为85.3%,特异度为82.5%。多因素Logistic分析显示,IgA>3.235g/L、D-D>0.415μg/mL、FDP>3.260μg/mL均为HSP复发的独立因素(P<0.05)。结论:IgA、D-D、FDP水平对HSP疾病复发具有一定的预测价值,监测三者水平有利于评估预后情况。

Objective:To explore the relationship between immunoglobulin A(IgA),D-dimer(D-D),fibrinogen degradation products(FDP)levels,and disease recurrence in children with Henoch-Schonlein Purpura(HSP).Methods:A total of 160 children with HSP admitted to our hospital from November 2022 to April 2023 were selected as the study subjects.IgA levels were measured using a fully automatic biochemical analyzer,and D-D and FDP levels were determined using a fully automatic blood coagulation analyzer.After a 6-month follow-up,the patients were divided into the recurrence group(n=34)and the non-recurrence group(n=136)based on the follow-up results.The levels of IgA,D-D,and FDP were compared between the two groups.Receiver operating characteristic(ROC)curves and area under the curve(AUC)were used to analyze the predictive value of each indicator for disease recurrence.Multifactorial logistic regression analysis was employed to assess the impact of various indicators on disease recurrence.Results:Children in the recurrence group had higher levels of IgA[3.305(2.565,4.402)g/L],D-D[1.470(0.477,2.742)μg/mL],and FDP[4.445(2.442,9.212)μg/mL]compared to the non-recurrence group with IgA[2.360(1.697,3.012)g/L],D-D[0.310(0.200,0.575)μg/mL],and FDP[1.920(1.140,2.890)μg/mL],and the differences were statistically significant(P<0.05).ROC curve analysis revealed that the AUC for the combined prediction of IgA,D-D,and FDP for disease recurrence in HSP children was 0.892,higher than individual indicators,with a sensitivity of 85.3%and specificity of 82.5%.Multifactorial logistic analysis showed that IgA>3.235 g/L,D-D>0.415μg/mL,and FDP>3.260μg/mL were independent factors for HSP recurrence(P<0.05).Conclusion:IgA,D-D,and FDP levels have a certain predictive value for disease recurrence in HSP.Monitoring the levels of these three indicators is beneficial for evaluating the prognosis.