口服免疫调节剂治疗并联合检测维生素D水平与小儿过敏性紫癜的相关性

Correlation analysis between oral immunomodulator therapy and combined detection of vitamin D level and Henoch-Schonlein purpura in children

目的口服免疫调节剂治疗并联合检测维生素D水平与小儿过敏性紫癜的相关性。方法选取2016年8月~2019年12月共收治的80例过敏性紫癜患儿作为研究对象,对所有患者应用口服免疫调节剂治疗,58例患儿治疗效果显著,皮肤紫癜情况明显减少,且症状减轻,将其分为治疗有效组。22例患儿治疗效果不明显,皮肤紫癜无明显改善,临床症状无改善甚至加重,将这类患儿分为治疗无效组。对比两组患儿血清25(OH)D、IgA水平、尿蛋白指标和外周血T细胞亚群指标,并分析上述指标与过敏性紫癜的相关性。结果治疗后,两组患儿25(OH)D水平与血清IgA水平对比差异显著(P<0.05);两组患儿尿蛋白中TRF、IgG、pZ-MG、MA指标对比差异显著(P<0.05);两组患儿外周血T细胞亚群指标CD4^(+)/CD8^(+)、CD8^(+)、CD4^(+)对比差异显著(P<0.05),CD3^(+)对比差异无统计学意义(P>0.05);Spearman相关分析结果显示:血清IgA、TRF、IgG、MA、CD4^(+)/CD8^(+)与小儿过敏性紫癜呈负相关(P<0.05),25(OH)D、pZ-MG、CD8^(+)、CD4^(+)与小儿过敏性紫癜呈正相关(P<0.05)。结论对过敏性紫癜患儿应用口服免疫调节剂治疗并对患儿进行维生素D检测,能够分析患儿治疗情况与维生素D的相关性,并可以应用尿蛋白相关指标、外周血T细胞亚群指标、维生素D水平以及血清IgA水平判断过敏性紫癜患儿的预后情况。

Objective To analyze the correlation between oral immunomodulator treatment and combined detection of vitamin D level and children with allergic purpura.Methods A total of 80 children with Henoch-Schonlein purpura admitted from August 2016 to December 2019 were selected as the research objects.All patients were treated with oral immunomodulators.The treatment effect of 58 children was significant,and the condition of skin purpura was significantly reduced,and symptoms are reduced,and they are divided into treatment effective groups.The treatment effect of 22 children was not obvious,the skin purpura had no obvious improvement,and the clinical symptoms had no improvement or even worsened.These children were divided into the treatmentineffective group.The serum 25(OH)D,IgA levels,urine protein indexes and peripheral blood T cell subset indexes were compared between the two groups of children,and the correlation between the above indexes and Henoch-Schonlein purpura was analyzed.Results After treatment,the 25(OH)D levels and serum IgA levels of the two groups of children were significantly different(P<0.05);the two groups of children had significant differences in urine protein indexes of TRF,IgG,pZ-MG and MA(P<0.05);The comparison of peripheral blood T cell subgroup indexes CD4^(+)/CD8^(+),CD8^(+),CD4^(+)between the two groups of children was significantly differen(t P<0.05),and there was no significant difference in CD3^(+)comparison(P>0.05);Spearman correlation analysis results showed:serum IgA,TRF,IgG,MA,CD4^(+)/CD8^(+)are negatively correlated with pediatric allergic purpura(P<0.05),25(OH)D,pZ-MG,CD8^(+),CD4^(+)are positively correlated with pediatric allergic purpura(P<0.05).Conclusion The application of oral immunomodulators for the treatment of children with Henoch-Schonlein purpura and the detection of vitamin D in the children can analyze the correlation between the children's treatment and vitamin D,and can use indicators related to urine protein,peripheral blood T cell subsets,vitamin D level and serum IgA level to judge the prognosis of children with Henoch-Schonlein purpura.