咽拭子A群链球菌抗原快速检测在过敏性紫癜儿童及肾损伤检测诊断中的价值分析

An Analysis of the Value of Rapid Detection of Group A Streptococcus Antigen in Throat Swab in the Diagnosis of Children with Henoch-Schonlein Purpura and Renal Function Damage

目的对过敏性紫癜儿童咽拭子A群链球菌抗原快速检测结果与肾功能损害检测结果之间的关系进行探讨分析。方法选取2018年3月至2019年3月在本院皮肤科及风湿免疫科就诊的过敏性紫癜患儿89例,采用免疫散射比浊法检测尿特定蛋白:微量白蛋白(mAlb)、尿转铁蛋白(TRF)、α1-微球蛋白(α1-MG)、尿免疫球蛋白(UIgG)四项;用胶体金法检测咽拭子A群链球菌抗原。结果通过对89例过敏性紫癜特定蛋白四项结果分析得出:有肾功能损害指标的38例(42.70%),学龄前(3~6岁)组有16例(38.10%)感染了A群链球菌,学龄(7~12岁)组中有19例(40.43%)感染了A群链球菌,两组之间A群链球菌感染率年龄差异无统计学意义(χ2=4.348,P>0.05),在A群链球菌感染35例阳性组中,存在肾损害的患儿共有26例(74.29%),其明显高于链球菌感染阴性组中的12例(22.22%)肾损害病例(χ2=30.775,P<0.05)。结论过敏性紫癜儿童合并A群链球菌感染后增加了肾功能损害风险,咽拭子A群链球菌抗原快速检测,有利于快速鉴别诊断过敏性紫癜儿童是否存在A群链球菌感染。

Objective To explore the correlation between detection results of the rapid detection of group A Streptococcus antigen in throat swab and renal function damage in children with Henoch-Schonlein purpura.Methods 89 children with Henoch-Schonlein purpura were selected from March, 2018 to March, 2019 in the Dermatological Department and the Department of Rheumatology and Immunology of our hospital. Four specific proteins in urine, including microalbumin(mAlb), urinary transferrin(TRF), α1-microglobulin(α1-MG) and urinary immunoglobulin(UIgG), were detected by immunoturbidimetry, and group A Streptococcus antigen in throat swab was detected by colloidal gold method.Results The results of 4 specific proteins of 89 patients with Henoch-Schonlein purpura were analyzed: 38(42.70%) with renal function damage indicators, 16 out of 42 cases of the 3-to-6 years old group(38.10%) infected with group A Streptococcus, and 19 out of 47 cases of the 7-to-12 years old group infected with group A Streptococcus. Between the two groups, group A Streptococcus infection rate had no age difference(χ2=4.348,P>0.05). Among 35 cases of Streptococcus infection positive, a total of 26(74.29%) cases had renal function damage which was significantly higher than 12(22.22%) cases of renal function damage in the negative group of Streptococcus infection(χ2=30.775,P<0.05).Conclusion There is an increased risk of renal damage after combining group A Streptococcal infection in children with Henoch Schonlein purpura. The rapid detection of group A Streptococcal antigen in throat swab is conducive to the rapid differential diagnosis of group A Streptococcal infection in children with Henoch Schonlein purpura.