过敏性紫癜血清中某些细胞因子和IgA1含量变化的临床意义

Clinical significance of serum cytokines and IgA1 changes in patients with allergic purpura

目的观察普通过敏性紫癜(GHSP)及紫殿性肾炎(HSPN)患儿血清白细胞介素21(IL-21)、转化生长因子β(TGF-β)、肿瘤坏死因子α(TNF-α)和免疫球蛋白A1(IgA1)含量,进一步探讨过敏性紫癜(HSP)及HSPN的发病机制,为临床诊断和治疗HSP提供新思路。方法抽取2014年1月~2016年1月在河北北方学院附属第一医院儿科住院治疗的65例HSP(38例GHSP,27例HSPN)患儿和30例健康儿童(对照组)外周血,离心后分离血清,采用双抗夹心酶联免疫吸附法(ELISA)检测血清IL-21、TGF-β、TNF-α、IgA1含量,对结果进行统计学分析。结果 HSP患儿IL-21、TGF-β、TNF-α、IgA1水平均高于对照组(P<0.05),且HSPN患儿TGF-β、TNF-α、IgA1水平均明显高于GHSP患儿(P<0.05),而IL-21水平在两组患儿之间差异无统计学意义(P>0.05)。HSPN患儿血清TGF-β与IgA1呈正相关(r=0.346,P<0.05),TNF-α与IgA1呈正相关(r=0.582,P<0.05)。结论 IL-21、TGF-β、TNF-α和IgA1参与GHSP及HSPN的发病及病情进展,血清IgA1含量可作为判断HSPN患儿预后的重要指标之一。

Objective To observe the contents of IL-21, TGF-β, TNF-α and IgA1 in patients with general Henoch- Sch nlein purpura （GHSP） and Henoch-Sch nlein purpura nephritis （HSPN）, and further explore the pathogenesis of HSP and HSPN, in order to provide new ideas for diagnosis and treatment of HSP in clinic. Methods 65 children with HSP （38 children with GHSP, 27 children with HSPN） hospitalized in Department of Pediatric Internal, the First Affiliated Hospital of Hebei North University from January 2014 to January 2016 were selected. At the same time 30 healthy children who did health examination in the same hospital were selected randomly as control group. Their serum were collected for test after centrifugation, the contents of serum IL-21, TGF-β, TNF-α and IgA1 were detected by double- antibody sandwich enzyme-linked immunosorbent assay method （ELISA）. The results were analyzed statistically. Re- suits The contents of serum IL-21, TGF-β, TNF-α and IgA1 in children with HSP were significantly higer than those of the control group （P 〈 0.05）; and the contents of serum TGF-β, TNF-α, IgA1 in children with HSPN were higher than those of the children with GHSP （P 〈 0.05）, but the content, of serum IL-21 had no significant difference between the two groups （P 〉 0.05）. The contents of serum TGF-β and IgA1 in children with HSPN was positively correlated （r=0.346, P 〈 0.05）, while the contents of serum TNF-α and IgA1 in children with HSPN was also positively correlated （r=0.582, P 〈 0.05）. Conclusion IL-21, TGF-β, TNF-α and lgA1 are all involved in the occurrence and development process of GHSP and HSPN, and serum IgA1 is help to judge the prognosis of patients with HSPN.