血清B淋巴细胞激活因子水平对初诊特发性血小板减少性紫癜患儿疗效的预测价值

Predict Value of Serum B-Cell Activating Factor on Treatment Effectiveness of Children with Idiopathic Thrombocytopenic Purpura in Diagnosis

目的评价血小板减少性紫癜(ITP)患儿初诊时血清B淋巴细胞激活因子(BAFF)对其疗效的预测价值。方法采用ELISA法检测初诊37例ITP患儿与37例隐睾及腹股沟疝患儿(对照组)血清BAFF水平,分析ITP患儿血清BAFF水平与其血小板计数、治疗效果的关系。采用受试者工作曲线法(ROC)分析血清BAFF水平对治疗效果的预测价值。结果 ITP患儿血清BAFF水平较对照组增高(P=0.02),且与血小板计数呈负相关(R2=0.39,P<0.01)。初诊时血清BAFF水平较低的患儿,其治疗效果相对较好(P<0.01)。采用初诊血清BAFF水平预测患儿治疗效果,其曲线下面积(AUC)为0.85(95%CI 0.72～0.97,P<0.01),当血清BAFF值为850 ng.L-1时,预测敏感性为0.71(95%CI 0.48～0.89),特异性为0.88(95%CI 0.62～0.98)。结论初诊血清BAFF水平有助于ITP患儿最终治疗效果的预测。

Objective To evaluate the predictive efficiency of serum B - cell activating factor （BAFF） on the treatment effectiveness in children with idiopathic thrombocytopenic purpura （[TP） in diagnosis. Methods Serum BAFF level of 37 children with ITP and controls （ consisted of cryptorchidism and inguinal hernia） were detected by enzyme - linked immunosorbent assay （ ELISA）. The correlations between serum BAFF and platelet count and treatment effectiveness were analyzed. The predictive efficiency of BAFF on ITP patients＇ treatment effectiveness was evaluated by receiver operating characteristics （ROC） curve analysis. Results Increased serum BAFF, which negatively correlated with platelet count, was observed in children with ITP. Higher serum BAFF at diagnosis was associated with worse treatment effectiveness, and vice versa. For treatment effectiveness predicting, the area under curve （AUC） for serum BAFF level was 0.85 （95% CI 0. 72 - 0.97, P 〈 0.01 ）. At the cut - off value of 850 ng·L^-1 , the sensitivity and specificity for serum BAFF level were 0.71 （95% CI 0. 48 - 0. 89 ） and 0.88 （ 95 % CI 0. 62 - 0.98 ） , respectively, as confirmed by ROC curve analysis. Conclusion The serum BAFF level at diagnosis was an useful biomarker to predict the treatment effectiveness in children with ITP.