血清IgE、IgA及MMP-13水平在复发性过敏性紫癜患儿中的表达及临床意义

Expression and clinical significance of IgE,IgA,and MMP-13 in children with recurrent henoch-schönlein purpura

目的探讨复发性过敏性紫癜(HSP)患儿血清中免疫球蛋白E(IgE)、免疫球蛋白A(IgA)以及基质金属蛋白酶-13(MMP-13)的表达水平及其临床意义,以此为临床治疗提供参考。方法选取2020年3月—2023年1月空军军医大学第二附属医院收治的HSP患儿161例为观察组,另选取同期于本院进行体检且各项正常儿童143例为对照组。观察组患儿于入院后次日清晨、对照组研究对象于体检当日早晨空腹状态下抽取静脉血5 mL。对比不同人群血清IgE、IgA、MMP-13水平,分析随访过程中观察组患儿复发情况;分析影响HSP患儿复发的单因素,采用多元logistic回归分析影响HSP复发的多因素。结果观察组患儿IgE、IgA、MMP-13水平均高于对照组,差异具有统计学意义(P<0.05)。经12个月的随访可知,161例HSP患儿中复发了36例(22.36%),其中再次出现关节疼痛15例,再次出现腹痛者10例,再次出现关节积液者7例,再次出现其他临床症状者4例,均归为复发组;随访期间,HSP患儿未出现临床症状的有125例(77.64%),归为未复发组。复发组患儿中饮食控制占比、血小板计数水平均低于未复发组,且乳酸脱氢酶、IgE、IgA、MMP-13水平均高于未复发组,差异均具有统计学意义(P<0.05)。多因素logistic回归分析结果显示:无饮食控制、血小板计数降低、乳酸脱氢酶水平升高、IgE水平升高、IgA水平升高、MMP-13水平升高为影响HSP复发的危险因素(P<0.05)。结论在复发性HSP患儿中,血清IgE、IgA及MMP-13水平均呈现上升趋势,并且三者同饮食不控制、血小板计数降低以及乳酸脱氢酶水平升高,均被视为影响HSP复发的危险因素。

Objective To investigate the expression levels of immunoglobulin E(IgE),immunoglobulin A(IgA),and matrix metalloproteinase-13(MMP-13)in the serum of children with recurrent Henoch-Schönlein purpura(HSP)and their clinical significance,aiming to provide a reference for clinical treatment.Methods A total of 161 children with HSP admitted to the Second Affiliated Hospital of Air Force Medical University from March 2020 to January 2023 were selected as the observation group,and 143 healthy children who underwent physical examination during the same period were selected as controls.Fasting venous blood of 5 mL was drawn from the children in the observation group on the morning after admission,and from the participants in the control group on the morning of the physical examination.The levels of serum IgE,IgA,and MMP-13 in different populations were compared,and the recurrence of HSP in the observation group during the follow-up process was analyzed.The univariate factors affecting the recurrence of HSP were analyzed,and multivariate logistic regression analysis was used to assess the multiple factors influencing the recurrence of HSP.ResultsThe levels of IgE,IgA,and MMP-13 in the observation group were significantly higher than those in the control group(P<0.05).After a 12-month follow-up,36 out of 161 HSP children recurred(22.36%),with 15 experiencing joint pain again,10 abdominal pain,7 joint effusion,and 4 other clinical symptoms,all of which were classified as the recurrence group.During the follow-up period,125 out of 161 HSP children(77.64%)did not demonstrate clinical symptoms and were classified as the non-recurrence group.The proportion of dietary control and platelet count in the recurrence group were lower than those in the non-recurrence group,and the levels of lactate dehydrogenase,IgE,IgA,and MMP-13 were higher than those in the non-recurrence group,with all differences being statistically significant(P<0.05).Multivariate logistic regression analysis results showed that lack of dietary control,reduced platelet count,elevated lactate dehydrogenase level,increased IgE level,increased IgA level,and increased MMP-13 level were risk factors influencing the prognosis and recurrence of HSP(P<0.05).Conclusion In children with recurrent HSP,the levels of IgE,IgA,and MMP-13 all show an increasing trend,and all three,along with lack of dietary control,reduced platelet count,and elevated lactate dehydrogenase level,are considered risk factors for HSP recurrence.