血清白三烯B4、血栓调节蛋白、基质金属蛋白酶-9、白细胞介素-4与小儿过敏性紫癜的发病关系

Relationship between the serum LTB4, TM, MMP-9, IL-4 and the attack of henoch schonlein purpura in children

目的研究过敏性紫癜患儿血清标记物白三烯B4(LTB4)、血栓调节蛋白(TM)、基质金属蛋白酶-9(MMP-9)、白细胞介素-4(IL-4)在血清中的表达,并探讨其联合动态检测在小儿过敏性紫癜发病中的作用。方法收集2013年1月至2014年6月我院收治的100例小儿过敏性紫癜患者为研究对象,其中单纯性紫癜27例定为常规亚组,伴有腹型、关节型、肾型、混合型共73例定为严重亚组,另选取50例健康儿童为健康对照组,采用酶联免疫法检测常规亚组、严重亚组(治疗前、治疗1个疗程后)及健康对照组血清LTB4、TM、MMP-9、IL-4水平,采用回顾性统计方法分析血清LTB4、TM、MMP-9、IL-4水平与小儿过敏性紫癜的发病关系。结果过敏性紫癜患儿治疗前常规亚组血清LTB4、TM、MMP-9、IL-4水平分别为(53.24±15.42)pg/ml、(145.36±22.14)ng/ml、(63.27±10.42)ng/ml、(76.31±15.29)pg/ml,严重亚组分别为(87.92±20.57)pg/ml、(197.59±34.38)ng/ml、(102.75±18.52)ng/ml、(134.57±30.41)pg/ml,明显高于健康对照组[(13.65±4.36)pg/ml、(76.23±11.54)ng/ml、(26.42±5.78)ng/ml、(35.36±8.79)pg/ml],且严重亚组血清水平明显高于常规亚组(均P<0.05);治疗后常规亚组血清LTB4、TM、MMP-9、IL-4水平分别为(14.87±5.11)pg/ml、(81.82±15.63)ng/ml、(29.12±6.78)ng/ml、(40.14±10.45)pg/ml,严重亚组分别为(36.81±7.25)pg/ml、(120.12±22.56)ng/ml、(42.37±8.63)ng/ml、(72.31±16.47)pg/ml,与组内治疗前比较明显降低,差异有统计学意义(P<0.05);过敏性紫癜患儿血清LTB4、TM、MMP-9、IL-4水平在不同性别、年龄中比较差异无统计学意义,但在不同病程、病情轻重间比较差异有统计学意义(均P<0.05)。结论血清LTB4、TM、MMP-9、IL-4水平变化与小儿过敏性紫癜明显相关,四项联合动态检测用于小儿过敏性紫癜诊断、病情评定及疗效观察具有重要临床价值。

Objective To investigate the serum level of LTB4, TM, MMP-9, IL-4 of henoch schonlein purpura in children and the effect of the attack LTB4, TM, MMP-9, IL-4 combined detection in the treatment of henoch schonlein purpura in children. Methods Collected data from 100 children patients with henoch schonlein purpura from People‘s Hospital of Rizhao between Jan. 2013 to Jun. 2014. Among these patients, selected 27 patients with simple purpura as a conventional subgroup, 73 patients with abdominal type, joint type, renal type, mixed type of henoch schonlein purpura as a serious subgroup, and 50 healthy children as a control group. Using ELISA to investigate the serum level of LTB4, TM, MMP-9, IL-4 in these three groups and then to analyze the relationship between the serum level of LTB4, TM, MMP-9, IL-4 and henoch schonlein purpura in children. Results Before the treatment, the conventional subgroups' serum level of LTB4, TM, MMP-9, IL-4 were respectively(53.24±15.42)pg/ml,(145.36±22.14)ng/ml,(63.27±10.42)ng/ml,(76.31±15.29)pg/ml, the serious subgroups' were respectively(87.92±20.57)pg/ml,(197.59±34.38)ng/ml,(102.75±18.52)ng/ml,(134.57±30.41)pg/ml and the control groups' were respectively(13.65±4.36)pg/ml,(76.23±11.54)ng/ml,(26.42±5.78)ng/ml,(35.36±8.79)pg/ml, so the serious subgroup's serum level of LTB4, TM, MMP-9, IL-4 were higher than the the conventional subgroup's(P<0.05) and the control group‘s. After the treatment,the conventional subgroups' serum level of LTB4, TM, MMP-9, IL-4 were respectively(14.87±5.11)pg/ml,(81.82±15.63)ng/ml,(29.12±6.78)ng/ml,(40.14±10.45)pg/ml, the serious subgroups' were respectively(36.81±7.25)pg/ml,(120.12±22.56)ng/ml,(42.37±8.63)ng/ml,(72.31±16.47)pg/ml and it was lower than pre-treatment, the differences were statically significant; The serum level of LTB4, TM, MMP-9, IL-4 in the children of henoch-schonlein purpura were independent of the sex and age while that were related to disease course, the severity of disease. Conclusion The serum level of LTB4, TM, MMP-9, IL-4 have the significant clinical value in the diagnosis and the treatment of henoch schonlein purpura in children.