过敏性紫癜患儿血清免疫指标及白细胞介素-6水平与疾病复发的相关性分析

Correlations of serum immune indexes and interleukin-6 levels with recurrence in children with Henoch-Schonlein purpura

目的探讨过敏性紫癜(Henoch-Schonlein purpura,HSP)复发患儿血清免疫球蛋白(immunoglobulin,Ig)E、IgA、补体C3及白细胞介素-6(interleukin-6,IL-6)水平及其与HSP复发的关系。方法 HSP患儿160例,其中复发性HSP患儿80例为观察组,未复发HSP患儿80例为对照组。检测患儿IgE、IgA、补体C3及IL-6水平,并进行2组间比较;采用双变量Pearson直线相关性分析HSP复发患儿血清IgE、IgA、补体C3、IL-6水平的相关性;采用多因素logistic回归分析HSP复发的影响因素;绘制ROC曲线,分析HSP患儿血清IgE、IgA、补体C3及IL-6水平对HSP复发的预测价值。结果观察组IgE[(195.36±21.25)u/L]、IgA[(3.58±0.98)g/L]、C3[(1.48±0.52)g/L]、IL-6[(16.58±5.51)ng/L]水平均高于对照组[(172.35±15.34)u/L、(3.05±0.65)g/L、(1.12±0.31)g/L、(12.68±3.34)ng/L](P<0.05)。HSP复发患儿血清IgE、IgA、C3、IL-6之间两两均呈正相关(r>0,P<0.05);血清IgE(OR=1.080,95%CI:1.044~1.117,P<0.001)、IgA(OR=2.883,95%CI:1.142~7.276,P<0.001)、补体C3(OR=8.654,95%CI:1.906~18.641,P<0.001)及IL-6(OR=1.647,95%CI:1.316~2.063,P<0.001)是HSP复发的影响因素;当IgE、IgA、补体C3和IL-6最佳截断值分别为162.345u/L、2.125g/L、1.010g/L、14.295ng/L时,预测HAP复发的AUC分别为0.834(95%CI:1.258~3.658)、0.817(95%CI:1.034~2.354)、0.753(95%CI:0.914~1.385)、0.840(95%CI:0.752~1.024),灵敏度分别为93.8%、97.5%、87.5%和88.8%,特异度分别为86.7%、83.8%、83.8%和83.8%。结论血清IgE、IgA、补体C3、IL-6过表达可能是HSP复发的影响因素,对预测HSP复发有一定价值。

Objective To explore the levels of serum immunoglobulin(Ig) E, IgA, complement C3 and interleukin-6(IL-6) in children with recurrence of Henoch-Sch?nlein purpura(HSP) and their correlations with the recurrence of HSP. Methods Totally 160 children with HSP were equally divided into recurrent HSP(observation group) and non-recurrent HSP(control group). The levels of IgE, IgA, complement C3 and interleukin-6(IL-6) were compared between two groups. Bivariate Pearson linear correlation was used to analyze the correlations among IgE, IgA, complement C3 and IL-6. Multivariate logistic regression was used to analyze the influencing factors for the recurrence of HSP. ROC was drawn to analyze the values of serum IgE, IgA, complement and IL-6 levels to the prediction of recurrence of HSP in children. Results The levels of IgE, IgA, complement C3 and IL-6 were significantly higher in observation group((195.36±21.25) u/L,(3.58±0.98) g/L,(1.48±0.52) g/L,(16.58±5.51) ng/L) than those in control group((172.35±15.34) u/L,(3.05±0.65) g/L,(1.12±0.31) g/L,(12.68±3.34) ng/L)(P<0.05). IgE, IgA, complement C3 and IL-6 were correlated positively with each other(r>0, P<0.05). IgE(OR=1.080, 95%CI:1.044-1.117,P<0.001),IgA(OR=2.883,95%CI:1.142-7.276,P<0.001),complement C3(OR=8.654,95%CI:1.906-18.641,P<0.001)and IL-6(OR=1.647,95%CI:1.316-2.063,P<0.001)were the influencing factors for the recurrence of HSP.When the optimal cut-off values of IgE,IgA,complement C3 and IL-6 were162.345 u/L,2.125 g/L,1.010 g/L and 14.295 ng/L,the AUCs for predicting the recurrence of HSP were 0.834(95%CI:1.258-3.658),0.817(95%CI:1.034-2.354),0.753(95%CI:0.914-1.385)and 0.840(95%CI:0.752-1.024),with the sensitivities of 93.8%,97.5%,87.5% and 88.8%,and the specificities of 86.7%,83.8%,83.8% and 83.8%,respectively.Conclusion The over-expressions of serum IgE,IgA,complement C3 and IL-6 might be the influencing factors for HSP recurrence,and have certain values to the prediction of HSP recurrence.