血清25-(OH)D水平与过敏性紫癜并发肾损害的相关性分析

Correlation analysis between serum 25-(OH) D level and renal damage in henoch-schonlein purpura

目的分析血清25-羟维生素D[25-(OH)D]水平与过敏性紫癜(HSP)并发肾损害的相关性。方法选择2018年1月至2020年12月在广东省中山市人民医院普通儿科住院的113例初诊为HSP且未经糖皮质激素及免疫抑制剂治疗的患儿作为HSP组,并根据是否合并肾损害将其分为紫癜性肾炎组(HSPN组,26例)和非紫癜性肾炎组(NHSPN组,87例)。另选取同期在我院门诊进行健康体检的60名儿童作为健康对照组。均检测各组儿童的血清25-(OH)D水平,并使用二元Logistic回归分析方法分析血清25-(OH)D预测HSP发病及并发肾损害的风险。结果HSP组的血清25-(OH)D水平明显低于健康对照组,HSPN组的血清25-(OH)D水平低于NHSPN组和健康对照组,差异均具有统计学意义(P<0.05)。血清25-(OH)D水平升高1 ng/mL,发生HSP风险的概率降低为原来的0.749倍,发生HSP并发肾损害风险的概率降低为原来的0.892倍。二元Logistic回归分析结果显示:血清25-(OH)D为HSP发病及并发肾损害的保护性因素(P<0.05)。结论血清25-(OH)D为HSP发病及并发肾损害的保护性因素,适当补充维生素D、提高血清25-(OH)D水平可能会降低HSP发病及并发肾损害的风险。

Objective To analyze the correlation between serum 25-hydroxy vitamin D [25-(OH)D] level and renal damage in henoch-schonlein purpura(HSP).Methods A total of 113 children newly diagnosed with HSP and not treated with glucocorticoids and immunosuppressants in general pediatrics department of Zhongshan city people’s hospital of Guangdong province from January 2018 to December 2020 were selected as HSP group,and divided into henoch-schonlein purpura nephritis group(HSPN group,26 cases) and non henoch-schonlein purpura nephritis group(NHSPN group,87 cases)according to whether they were complicated with renal damage.Another 60 children who underwent physical examination in our hospital in the same period were selected as healthy control group.The level of serum 25-(OH) D was detected in children of each group,and the risk of HSP and renal damage were predicted by binary Logistic regression analysis method.Results The serum 25-(OH) D level of the HSP group was significantly lower than that of the healthy control group,and the serum 25-(OH) D level of the HSPN group was lower than that of the NHSPN group and the healthy control group,and the differences were statistically significant(P<0.05).When the serum 25-(OH) D level increased by 1 ng/mL,the probability of HSP risk decreased to 0.749 times,and the probability of HSP complicated with renal damage decreased to 0.892 times.The binary Logistic regression analysis result showed that serum 25-(OH) D was a protective factor for the onset of HSP and renal damage(P<0.05).Conclusion Serum 25-(OH) D is a protective factor for the onset of HSP and renal damage.Appropriate supplementation of vitamin D and increasing the level of serum 25-(OH) D may reduce the risk of the onset of HSP and renal damage.