过敏性紫癜患儿血清CRP、IL-21及TNF-α的水平变化及临床应用价值分析

Changes of Serum CRP, IL-21 and TNF-α Levels in Children with Henoch-Schonlein Purpura and Their Clinical Value

目的:探究过敏性紫癜(HSP)患儿血清CRP、IL-21及TNF-α的水平变化及临床应用价值。方法:选取2017年2月-2019年2月本院收治的130例HSP患儿为HSP组,另选同期于本院体检的健康儿童60例作为对照组。随访半年,分析过敏性紫癜患者并发早期肾炎与血清CRP、IL-21及TNF-α水平的关系。结果:HSP组CRP、TNF-α水平均明显高于对照组,IL-21低于对照组(P<0.05);随访半年期间,130例患儿并发早期紫癜性肾炎(HSPN组)有55例,无并发肾炎(普通HSP组)75例,HSPN组血清CRP、TNF-α水平均明显高于普通HSP组(P<0.05);根据ROC曲线结果显示,CRP+IL-21+TNF-α联合检测SP患儿并发早期肾炎的敏感度94.55%,特异度93.33%,准确度94.62%,明显高于单独检测,差异有统计学意义(P<0.05)。结论:血清CRP、IL-21、TNF-α均参与HSP的发病机制,CRP+IL-21+TNF-α联合检测HSPN的敏感度、特异度及准确度更高,可作为HSPN早期诊断的重要指标。

Objective:To explore the changes of serum CRP,IL-21 and TNF-α levels in children with Henoch-Schonlein purpura (HSP) and their clinical value.Method:The total of 130 children with HSP admitted to our hospital from February 2017 to February 2019 were selected as HSP group,and 60 healthy children who underwent physical examination in our hospital during the same period were selected as control group.The relationship between early nephritis and serum levels of CRP,IL-21 and TNF-α in patients with Henoch-Schonlein purpura was analyzed.Result:The levels of CRP and TNF-α in HSP group were significantly higher than those in control group,and IL-21 was lower than those in control group (P<0.05).During the follow-up period of half a year,55 cases of 130 children complicated with early Henoch-Schonlein purpura nephritis (HSPN group) and 75 cases without complicated nephritis (HSP group).The levels of CRP and TNF-α in HSPN group were significantly higher than those in HSP group (P<0.05).The results of ROC curve showed that the sensitivity,specificity and accuracy of CRP + IL-21 + TNF-α combined detection in children with SP complicated with early nephritis were 94.55%,93.33% and 94.62%,respectively,which were significantly higher than those of single detection (P<0.05).Conclusion:Serum CRP,IL-21 and TNF-α are all involved in the pathogenesis of HSP.The sensitivity,specificity and accuracy of combined detection of CRP + IL-21 + TNF-α for HSPN are higher,which can be used as an important index for early diagnosis of HSPN.