血清降钙素原、纤维蛋白降解产物联合单核细胞趋化蛋白-1检测在儿童过敏性紫癜中的临床价值探讨

Clinical value of serum procalcitonin,fibrin degradation product combined with monocyte chemoattractant protein-1 detection in children with Henoch-Schonlein purpura

目的研究血清降钙素原(PCT)、纤维蛋白降解产物(FDP)联合单核细胞趋化蛋白-1(MCP-1)检测在儿童过敏性紫癜(HSP)中的临床价值。方法采集本院2017年11月—2019年10月收治的174例HSP患儿,其中无肾脏损水平,分析HSP肾损害者和24 h尿蛋白定量的相关性,并观察血清PCT、FDP联合MCP-1对过敏性紫癜肾损害的预测价值。结果HSP组血清PCT、FDP联合MCP-1水平较对照组高(P<0.05),HSP有肾脏损害组血清PCT、FDP联合MCP-1水平较无肾脏损害组高(P<0.05)。儿童HSP肾损害组血清PCT、FDP联合MCP-1与24 h尿蛋白定量均呈正相关(r值分别为0.602、0.563、0.591,P<0.05)。ROC曲线分析显示,血清PCT对儿童HSP肾损害预测的AUC为0.733、灵敏度为0.538、特异度为0.881,FDP的AUC为0.788、灵敏度为0.692、特异度为0.798,MCP-1的AUC为0.750、灵敏度为0.677、特异度为0.691,PCT+FDP+MCP-1的ACU为0.883、灵敏度为0.785、特异度为0.807,PCT+FDP+MCP-1的AUC大于PCT、FDP及MCP-1单个指标。结论血清PCT、FDP联合MCP-1在儿童HSP发生发展中有重要作用,且可作为早期诊断HSP及预测肾损害的参考指标。

Objective To study the clinical value of serum procalcitonin(PCT),fibrin degradation product(FDP)and monocyte chemoattractant protein-1(MCP-1)detection in children with Henoch-Schonlein purpura(SHP).Methods 174 cases of Henoch-Schonlein purpura in children admitted to our hospital from November 2017 to October 2019 were collected,including 109 cases without renal damage and 65 cases with renal damage.165 cases of healthy children in our hospital's outpatient department were selected as control group at the same time.The levels of serum PCT,FDP and MCP-1 in each group were compared,the correlation between renal damage in children with Henoch-Schonlein purpura and 24 h urine protein quantification was analyzed,and the predictive value of serum PCT,FDP and MCP-1 on renal damage in Henoch-Schonlein purpura was observed.Results Serum PCT,FDP and MCP-1 levels in HSP group were higher than those in control group(P<0.05),serum PCT,FDP and MCP-1 levels in HSP group with kidney damage were higher than those in group without kidney damage(P<0.05).Serum PCT,FDP combined with MCP-1 in children with HSP kidney damage were positively correlated with 24h urine protein(r=0.602,r=0.563,r=0.591,P<0.05).ROC curve analysis showed that the AUC of serum PCT for predicting renal damage in children with HSP was 0.733,the sensitivity was 0.538,and the specificity was 0.881,AUC of FDP was 0.788,sensitivity was 0.692,specificity was 0.798,the AUC of MCP-1 was 0.750,the sensitivity was 0.677,and the specificity was 0.691,the ACU of PCT+FDP+MCP-1 was 0.883,the sensitivity was 0.785,and the specificity was 0.807,AUC of PCT+FDP+MCP-1 was larger than single indexes of PCT,FDP and MCP-1.Conclusion Serum PCT,FDP and MCP-1 play an important role in the occurrence and development of HSP in children,and can be used as a reference index for early diagnosis of HSP and prediction of renal damage.