过敏性紫癜患儿总IgE、IgA及补体C3水平对疾病预后的预测价值

The predictive value of total IgE, IgA and complement C3 for prognosis in children with Henoch-Schonleinpurpura

目的探讨过敏性紫癜患儿住院时间及临床症状持续时间与总IgE、IgA及补体C3水平的相关性;研究过敏性紫癜患儿总IgE、IgA及补体C3水平的变化情况。方法选取蚌埠医学院第一附属医院2013年1月-2018年12月确诊为过敏性紫癜的住院患儿为研究对象,回顾性分析过敏性紫癜患儿血清变应原总IgE、IgA及补体C3水平情况。采用两独立样本t检验进行分析,并做多元回归分析,使用SPSS 22.0统计软件进行数据分析。结果总IgE水平升高患儿的住院时间长于总IgE水平正常的患儿,且皮疹、关节及消化道症状持续时间更长。补体C3水平降低患儿的住院时间及症状持续时间明显长于补体C3水平正常的患儿。IgA水平升高患儿的住院时间长于IgA水平正常的患儿,且皮疹、消化道及关节症状持续时间更长。而在多元回归分析中显示:总IgE水平与过敏性紫癜患儿的住院天数、皮疹、腹痛及关节痛持续天数有显著正向影响关系,补体C3水平仅与腹痛持续天数有显著负向影响关系,而IgA水平与患儿的住院天数、皮疹、关节肿痛及腹痛持续天数无显著相关性。结论过敏性紫癜患儿的总IgE水平可以作为评估和预测疾病转归的指标之一;过敏性紫癜患儿的总IgE比IgA和补体C3对疾病的预后更有预测价值;HSP患儿存在IgA、总IgE水平升高,同时存在补体C3水平下降情况。

Objective To investigate the relationship between hospital stays or duration of clinical symptoms and total immunoglobulin E levels in children who were diagnosed allergic purpura. To study the changes of total IgE, IgA and complement C3 in children with allergic purpura. Methods The hospitalized children diagnosed with allergic purpura in the First Affiliated Hospital of Bengbu Medical College from January 2013 to December 2018 were selected as research objects, and the serum allergen total IgE, IgA and complement C3 levels in children with allergic purpura were retrospectively analyzed. T-test of two independent samples was used for analysis, and multivariate regression analysis was performed. SPSS 22.0 software was used for data analysis. Results The total IgE levels with the length of hospital stay longer than the total IgE level of normal children, and skin rashes, joints, and the digestive tract symptoms last longer. The hospital stays and symptoms duration of children with reduced complement C3 levels were significantly higher than those with normal complement C3 levels. Children with elevated IgA levels had longer hospital stays than those with normal IgA levels, and the rash, gastrointestinal and joint symptoms lasted longer. The multiple regression analysis showed that the total IgE level had a significant positive correlation with the number of days of hospitalization, rash, abdominal pain and joint pain duration in children with allergic purpura, while the complement C3 level had a significant negative correlation with the number of days of abdominal pain duration, while the IgA level had no significant correlation with the number of days of hospitalization, rash, joint pain and abdominal pain duration. Conclusions The total IgE level of children with allergic purpura can be used as one of the indexes to evaluate and predict the disease outcome. Compared with IgA and C3, the total IgE of children with allergic purpura is more predictive of prognosis. The levels of IgA and IgE are increased in HSP children, while the levels of complement C3 are decreased.