LTB4和LTFA联合检测在早期诊断过敏性紫癜患儿肾脏受累中的应用及对预后的影响

The value of combined detection of LTB4 and LTFA in early diagnosis of renal involvement in children with henoch schonlein purpura and its influence on prognosis

目的探讨白三烯B4(LTB4)和白三烯E4(LTFA)联合检测在早期诊断过敏性紫癜患儿肾脏受累(HSPN)中的应用及对预后的影响。方法选取2014年1月至2016年10月青岛市妇女儿童医院收治的185例HSPN患儿为研究对象(HSPN组),选取同期体检健康的儿童50例为对照组。检测所有对象血清LTB4和LTFA含量,并分析其在HSPN早期诊断中的价值及对预后的影响。结果与对照组相比,HSPN患儿血清LTB4和LTFA含量明显升高,差异有统计学意义(P<0.05)。受试者工作特征曲线(ROC曲线)分析LTB4和LTFA联合检测诊断价值,HSPN曲线下面积为0.899,敏感度为0.810,均优于LTB4和LTB4单独检测,差异有统计学意义(P<0.05)。平均随访(28.4±10.3)个月,A级预后133例(71.9%)、B级预后47例(25.4%)、C级预后5例(2.7%)。秩和检验结果显示,LTB4<987.6ng/L的患儿预后优于LTB4≥987.6ng/L的患儿,LTFA<896.3ng/L的患儿预后优于LTFA≥896.3ng/L的患儿。Spearman分析,LTB4和LTFA含量与预后呈负相关(r分别为-0.693、-0.637,P<0.05),含量越高,预后越差。结论联合检测LTB4和LTFA对于早期诊断HSPN以及预后判断均具有重要的临床意义。

Objective To investigate the value of leukotriene B4(LTB4)and leukotriene E4(LTFA)in early diagnosis of renal involvement in children with Henoch Schonlein purpura(HSPN)and its influence on prognosis.Methods A total of185children with HSPN were enrolled in our hospital from January2014to October2016.A total of50healthy children were selected as control group at the same period.The serum levels of LTB4and LTFA in all subjects were detected,and their value in early diagnosis of HSPN and its influence on prognosis were analyzed.Results Compared with the control group,the serum levels of LTB4and LTFA in children with HSPN were significantly higher(P<0.05),the contents were987.6ng/L and896.3ng/L,respectively.The AUC of the combined detection of HSPN was0.899and the sensitivity was0.810,which was better than that of LTB4and LTB4alone(P<0.05).The average followup was(28.4±10.3)months,with grade A prognosis in133cases(71.9%),B grade in47cases(25.4%),and C grade in5cases(2.7%).The rank sum test showed,the prognosis of children with LTB4<987.6ng/L was better than that of children with LTB4≥987.6ng/L,the prognosis of children with LTFA<896.3ng/L was better than that of children with LTFA≥896.3ng/L.Spearman analysis showed that the content of LTB4and LTFA was negatively correlated with prognosis(Rs=-0.693and-0.637,P<0.05).The higher contents of LTB4and LTFA,the worse the prognosis.ConclusionCombined detection of LTB4and LTFA has important clinical significance for early diagnosis and prognosis of HSPN.serum levels of LTB4and LTFA in children with HSPN were significantly higher(P<0.05),the contents were987.6ng/L and896.3ng/L,respectively.The AUC of the combined detection of HSPN was0.899and the sensitivity was0.810,which was better than that of LTB4and LTB4alone(P<0.05).The average followup was(28.4±10.3)months,with grade A prognosis in133cases(71.9%),B grade in47cases(25.4%),and C grade in5cases(2.7%).The rank sum test showed,the prognosis of children with LTB4<987.6ng/L was better than that of children with LTB4≥987.6ng/L,the prognosis of children with LTFA<896.3ng/L was better than that of children with LTFA≥896.3ng/L.Spearman analysis showed that the content of LTB4and LTFA was negatively correlated with prognosis(Rs=-0.693and-0.637,P<0.05).The higher contents of LTB4and LTFA,the worse the prognosis.Conclusion Combined detection of LTB4and LTFA has important clinical significance for early diagnosis and prognosis of HSPN.selected as control group at the same period.The serum levels of LTB4and LTFA in all subjects were detected,and their value in early diagnosis of HSPN and its influence on prognosis were analyzed.ResultsCompared with the control group,the serum levels of LTB4and LTFA in children with HSPN were significantly higher(P<0.05),the contents were987.6ng/L and896.3ng/L,respectively.The AUC of the combined detection of HSPN was0.899and the sensitivity was0.810,which was better than that of LTB4and LTB4alone(P<0.05).The average followup was(28.4±10.3)months,with grade A prognosis in133cases(71.9%),B grade in47cases(25.4%),and C grade in5cases(2.7%).The rank sum test showed,the prognosis of children with LTB4<987.6ng/L was better than that of children with LTB4≥987.6ng/L,the prognosis of children with LTFA<896.3ng/L was better than that of children with LTFA≥896.3ng/L.Spearman analysis showed that the content of LTB4and LTFA was negatively correlated with prognosis(Rs=-0.693and-0.637,P<0.05).The higher contents of LTB4and LTFA,the worse the prognosis.ConclusionCombined detection of LTB4and LTFA has important clinical significance for early diagnosis and prognosis of HSPN.A total of185children with HSPN were enrolled in our hospital from January2014to October2016.A total of50healthy children were selected as control group at the same period.The serum levels of LTB4and LTFA in all subjects were detected,and their value in early diagnosis of HSPN and its influence on prognosis were analyzed.ResultsCompared with the control group,the serum levels of LTB4and LTFA in children with HSPN were significantly higher(P<0.05),the contents were987.6ng/L and896.3ng/L,respectively.The AUC of the combined detection of HSPN was0.899and the sensitivity was0.810,which was better than that of LTB4and LTB4alone(P<0.05).The average followup was(28.4±10.3)months,with grade A prognosis in133cases(71.9%),B grade in47cases(25.4%),and C grade in5cases(2.7%).The rank sum test showed,the prognosis of children with LTB4<987.6ng/L was better than that of children with LTB4≥987.6ng/L,the prognosis of children with LTFA<896.3ng/L was better than that of children with LTFA≥896.3ng/L.Spearman analysis showed that the content of LTB4and LTFA was negatively correlated with prognosis(Rs=-0.693and-0.637,P<0.05).The higher contents of LTB4and LTFA,the worse the prognosis.ConclusionCombined detection of LTB4and LTFA has important clinical significance for early diagnosis and prognosis of HSPN.