过敏性紫癜患儿血清中Cys C、TM与T淋巴细胞亚群的关系及易感因素分析

Study on Relationship between Serum Cys C,TM and T Lymphocyte Subsets in Children with Henoch-Schonlein Purpura

目的:分析过敏性紫癜(HSP)患儿血清中Cys C、TM与T淋巴细胞亚群的关系及易感因素。方法:2019年1月-2020年1月在本院就诊的HSP患者中选取100例设为观察组,选取同期健康体检儿童50例设为对照组,对两组Cys C、TM、T淋巴细胞亚群水平实施检测,并分析其相关性,以ROC曲线预测三种指标对HSP患儿的诊断价值,并分析易感因素。结果:相较于对照组,观察组Cys C、CD8^(+)、TM水平均明显升高,而CD4^(+)/CD8^(+)、CD4^(+)、CD3^(+)水平均下降,差异均有统计学意义(P<0.05)。观察组TM、Cys C与CD4^(+)/CD8^(+)、CD4^(+)、CD3^(+)均呈负相关(P<0.05),而与CD8^(+)呈正相关(P<0.05)。分析预测价值,对各指标临界值实施了辨别,均存在较高的特异度、灵敏度,Cys C、TM、T淋巴细胞亚群联合的AUC为0.917,灵敏度为93.4%,特异度为90.0%。单因素分析结果显示,两组性别、年龄、体重、先天性疾病史、上学情况等比较,差异均无统计学意义(P>0.05);而观察组春秋季节、空气污染、居住环境为工业区、长期服药、合并感染、食用海鲜等比例均高于对照组(P<0.05)。多因素logistic回归分析结果显示,春秋季节、空气污染、居住环境为工业区、长期服药、合并感染、食用海鲜均为HSP易感的危险因素。结论:HSP患儿血清内T淋巴细胞亚群、TM、Cys C有相关性存在,可联合对三者实施监测,以此提升儿童HSP的诊断准确率,尽量避免易感因素,预防HSP。

Objective:To study the relationship between Cys C,TM and T lymphocyte subsets in children with Henoch-Schonlein purpura (HSP).Method:From January 2019 to January 2020,100 HSP patients in our hospital were selected as the observation group,and 50 healthy children in the same period were selected as the control group,and the levels of Cys C,TM and T lymphocyte subsets were detected,their correlations were analyzed,and predict the value of three kinds of data for HSP children with ROC curve,the susceptible factors were analyzed.Result:Compared with the control group,the levels of Cys C,CD8^(+)and TM in the observation group were significantly increased,while CD4^(+)/CD8^(+),CD4^(+) and CD3^(+) levels were significantly decreased (P<0.05).In the observation group,TM and Cys C were negatively correlated with CD4^(+)/CD8^(+),CD4^(+) and CD3^(+) (P<0.05),but were positively correlated with CD8^(+) (P<0.05).The predictive value was analyzed,and the critical value of each index was discriminated,all of them had high specificity and sensitivity.The combined AUC of Cys C,TM,and T lymphocyte subsets was 0.917,the sensitivity was 93.4%,and the specificity was 90.0%.Univariate analysis showed that there were no significant differences in gender,age,weight,history of congenital diseases and schooling between two groups (P>0.05);while the proportion of children in the observation group in spring and autumn,air pollution,industrial living environment,long-term medication,complicated with infection and eating seafood were higher than those in the control group (P<0.05).Multivariate logistic regression analysis showed that spring and autumn season,air pollution,living environment in industrial area,long-term medication,complicated with infection and seafood consumption were risk factors of HSP susceptibility.Conclusion:There are correlations among T lymphocyte subsets,TM and Cys C in serum of children with HSP,which can be monitored jointly to improve the probability of correct diagnosis of children with HSP,avoid susceptible factors,and prevent the occurrence of HSP.