Midkine与儿童过敏性紫癜伴肾脏损害的相关性分析

Correlation between Midkine and child allergic purpura with renal damage

目的探讨Midkine与儿童紫癜性肾炎的的相关性。方法采集收治的83例过敏性紫癜患儿信息,其中41例合并肾脏损害。其中男性50名,女性33名;年龄2～14岁,平均6. 33岁。将患儿分为HSP组与HSPN组。收集2组患者血清中Midkine、IL-6、TNF与IgA、IgE、IgG、IgM的值,进行相关性分析。结果 HSP组与HSPN组在Midkine(283. 73±8. 23、321. 91±7. 10)、IL-6(16. 37±1. 17、17. 50±0. 95)、TNF(8. 80±0. 29、9. 71±0. 32)、IgA(2. 13±0. 08、2. 53±0. 21)、IgG(9. 81±1. 13、8. 19±1. 51)、IgM(1. 32±0. 19、1. 54±0. 17)方面的差异具有统计学意义;在IgE(123. 76±41. 21、139. 79±47. 62)方面的差异无统计学意义。Pearson相关性分析显Midkine与IL-6、TNF、IgA、IgM呈正相关,与IgG呈负相关,与IgE无相关性。ROC曲线分析显示,Midkine的下面积为0. 792。95%置信区间为0. 794～0. 890 (P <0. 05),诊断最佳临界值是305. 01 pg/mL。结论血清Midkine可作为诊断儿童紫癜性肾炎的有效指标。

Objective To investigate the correlation between Midkine and purpura nephritis in children with renal damage. Methods Eighty - three children with allergic purpura were collected. There were 50 males and 33 females,aged 2 ~ 14 years old,and average age was 6. 33 years old. There were 41 patients had kidney damage of the children. It was divided into HSP group and HSPN group. The serum Midkine,IL - 6,TNF and IgA,IgE,IgG and IgM were collected from the two groups for correlation analysis. Results The Midkine,IL - 6,TNF and IgA,IgE,IgG and IgM were respectively were Midkine ( 283.73 ± 8. 23 vs.321.91 ± 7.10) ,IL - 6 (16.37 ± 1.17 vs. 17.50 ± 0.95) ,TNF (8.80 ± 0.29 vs. 9.71 ± 0.32) , IgA (2.13 ± 0.08 vs.2.53 ± 0.21) ,IgG ( 9.81 ± 1.13 vs.8.19 ± 1.51) , IgM (1.32 ± 0.19 vs.1.54 ± 0.17) in group HSP and group HSPN,and the differences were statistically significant; there was no significant difference in IgE (123.76 ± 41. 21 vs. 139. 79 ± 47.62) . Correlation analysis showed that Midkine was positively correlated with IL - 6,TNF,IgA,IgM,and negatively correlated with IgG; there was no correlation between Midkine and IgE. The ROC curve analysis showed that the area under Midkine was 0. 792. The 95% confidence interval was 0. 794 ~ 0. 890 ( P<0.05) . The best diagnostic threshold was 305. 01 pg /mL. Conclusion Serum Midkine can be used as an effective indicator for the diagnosis of purpura nephritis in children.