淋巴细胞亚群、hs-CRP、TGF-β1水平与儿童原发性肾病综合征预后的关系研究

Study on the relationship between the levels of lymphocyte subsets,hs-CRP,TGF-β1 and the prognosis of children with primary nephrotic syndrome

目的分析淋巴细胞亚群(CD3^+、CD4^+、CD4^+/CD8^+)、超敏C反应蛋白(hs-CRP)、转化生长因子-β1(TGF-β1)水平与原发性肾病综合征(PNS)患儿预后的关系。方法选取2017年6月至2018年12月该院儿科收治的PNS患儿110例为研究组,同期于该院体检的60例健康儿童为对照组。比较研究组(治疗前)与对照组的淋巴细胞亚群、hs-CRP、TGF-β1水平;采用多因素Logistic回归分析影响PNS预后的独立危险因素;采用受试者工作特征曲线(ROC曲线)分析淋巴细胞亚群、hs-CRP、TGF-β1单独及联合检测对PNS预后的预测价值。结果研究组CD3^+、CD4^+、CD4^+/CD8^+水平均低于对照组,hs-CRP、TGF-β1水平均高于对照组,差异有统计学差异(P<0.05)。CD3^+、CD4^+、CD4^+/CD8^+、TGF-β1、hs-CRP是影响PNS预后的独立危险因素(P<0.05)。ROC曲线分析结果显示,CD3^+、CD4^+、CD4^+/CD8^+、hs-CRP及TGF-β15项联合检测预测PNS预后的曲线下面积为0.985,高于各项指标单独检测。结论淋巴细胞亚群、hs-CRP、TGF-β1水平与PNS预后密切相关,联合检测对PNS患儿预后评估具有一定价值。

Objective To analyze the relationship between the levels of lymphocyte subsets(CD3^+,CD4^+,CD4^+/CD8^+),high-sensitivity C reactive protein(hs-CRP),transforming growth factor-β1(TGF-β1)and the prognosis of children with primary nephrotic syndrome(PNS).Methods A total of 110 children with PNS treated in the department of pediatric in the hospital from June 2017 to December 2018 were selected as the study group,and 60 healthy children who underwent physical examination in the hospital during the same period were selected as the control group.The levels of lymphocyte subsets,hs-CRP and TGF-β1 in the study group(before treatment)and the control group were compared.Multivariate Logistic regression analysis was used to analyze the independent risk factors influencing the prognosis of PNS.Receiver operating characteristic curve(ROC)curve was used to analyze the predictive value of lymphocyte subsets,hs-CRP,TGF-β1 separated or combined detection for prognosis of PNS.Results The levels of CD3^+,CD4^+,CD4^+/CD8^+in the study group were lower than those in the control group,and the levels of hs-CRP and TGF-β1 were higher than those in the control group,and the differences were statistically significant(P<0.05).CD3^+,CD4^+,CD4^+/CD8^+,TGF-β1 and hs-CRP were independent risk factors influencing the prognosis of PNS(P<0.05).The results of ROC curve analysis showed that the area under the curve of CD3^+,CD4^+,CD4^+/CD8^+,hs-CRP and TGF-β1 combined detection in predicting the prognosis of PNS was 0.985,which was higher than separated detection.Conclusion The levels of lymphocyte subsets,hs-CRP and TGF-β1 are closely related to the prognosis of PNS,and combined detection has a certain value for the prognosis evaluation of PNS children.