过敏性紫癜患儿血清骨桥蛋白、可溶性基质溶素-2、维生素A、维生素D检测的临床意义

Clinical significance of serum osteopontin,soluble ST2,vitamin A and vitamin D in children with allergic purpura

目的探讨血清骨桥蛋白(OPN)、可溶性基质溶素-2(sST2)、维生素A(VitA)、维生素D水平与过敏性紫癜(HSP)患儿免疫功能以及HSP发病的关系。方法选择2018年1月至2019年10月该院儿科收治的83例HSP患儿(HSP组)和50例体检健康儿童(对照组)为研究对象,检测血清OPN、sST2、VitA、25-羟维生素D3[25-(OH)D3]水平,分析上述4个指标与免疫功能的关系及HSP发病的影响因素。结果HSP组血清OPN、sST2水平高于对照组,VitA、25-(OH)D3、补体C3、补体C4、IgA、CD4+T淋巴细胞水平低于对照组(P<0.05)。相关性分析结果显示HSP患儿血清OPN水平与CD4+T淋巴细胞水平呈负相关(P<0.05),sST2水平与CD4+T淋巴细胞水平呈负相关(P<0.05),VitA、25-(OH)D3水平与补体C3、补体C4、IgA、CD4+T淋巴细胞水平呈正相关(P<0.05)。多因素Logistic分析结果显示OPN、sST2水平升高,CD4+T淋巴细胞、VitA、25-(OH)D3水平降低是HSP发病的危险因素(P<0.05)。结论HSP患儿血清OPN、sST2水平升高,VitA、25-(OH)D3水平降低,且与免疫功能紊乱、HSP发病有关,监测OPN、sST2、VitA、25-(OH)D3水平可能有助于临床HSP的诊断。

Objective To investigate the relationship between serum osteopontin(OPN),soluble stromelysin-2(sST2),vitamin A(VitA),and vitamin D levels with immune function in children with allergic purpura(HSP).Methods From January 2018 to October 2019,83 children with HSP(HSP group)and 50 healthy children(control group)who were admitted to the Department of Pediatrics in the hospital were selected,the serum levels of OPN,sST2,VitA,25-(OH)D3 were tested.The relationship between the above four indicators and immune function,influencing factors of HSP were analyzed.Results Serum OPN and sST2 in HSP group were higher than those in control group(P<0.05),VitA,25-(OH)D3,complement C3,complement C4,IgA and CD4+T lymphocyte were lower than those in control group(P<0.05).Correlation analysis showed that the serum OPN level of children with HSP was negatively correlated with CD4+T lymphocyte level,sST2 was negatively correlated with CD4+T lymphocyte level(P<0.05),and VitA,25-(OH)D3 were positively correlated with complement C3,complement C4,IgA,CD4+T lymphocyte level(P<0.05).Multivariate Logistic analysis showed that the increase of OPN,ST2,the decrease of CD4+,VitA and 25-(OH)D3 were the risk factors of HSP(P<0.05).Conclusion The increase of serum OPN and sST2 and the decrease of VitA and 25-(OH)D3 in HSP children may be related to immune dysfunction and HSP.Monitoring of OPN,sST2,VitA,25-(OH)D3 may be helpful for clinical diagnosis of HSP.