嗜酸性粒细胞联合血清总IgE及纤维蛋白原对儿童过敏性紫癜的联合诊断价值

Diagnostic value of eosinophils combined with serum total IgE and fibrinogen in children with Henoch Schonlein purpura

目的探讨嗜酸性粒细胞联合血清总免疫球蛋白(immunoglobulin,Ig)E及纤维蛋白原(fibrinogen,FIB)对儿童过敏性紫癜(Henoch-Schonlein purpura,HSP)的联合诊断价值。方法选取2019年3月至2020年10月于成都市温江区妇幼保健院确诊为HSP的54例儿童作为观察组,将同时期健康体检的60例儿童作为对照组。采用全自动血液分析仪流式细胞计数法对嗜酸性粒细胞进行分类计数,酶联免疫吸附测定(enzyme linked immunosorbent assay,ELISA)实验对血清总IgE进行测定,全自动凝血分析仪免疫比浊法对FIB进行检测。分析嗜酸性粒细胞、血清总IgE及FIB对儿童HSP的联合诊断价值。结果流式细胞计数法结果显示,观察组嗜酸性粒细胞水平显著高于对照组,组间差异有统计学意义[(4.85±0.92)比(2.88±0.34),t=8.33,P<0.05]。与对照组相比,观察组FIB及D-D水平显著升高,组间差异均有统计学意义[(2.32±0.59)g/L比(3.82±0.87)g/L,(328.95±61.21)ug/L比(562.62±65.92)ug/L,t值分别为8.62、9.32,P值均<0.05]。嗜酸性粒细胞、血清总IgE及FIB单独诊断HSP的灵敏度分别为72.19%、90.24%和75.21%,特异性分别为89.32%、81.19%和65.38%,三者联合诊断HSP的灵敏度为91.28%,特异性为90.77%。结论嗜酸性粒细胞联合血清总IgE及FIB对儿童HSP有更高的诊断效能。

Objective To investigate the diagnostic value of eosinophils combined with serum total immunoglobulin(Ig)E and fibrinogen(FIB)in children with Henoch Schonlein purpura(HSP).Methods Total of 54 children with HSP in Chengdu Wenjiang Maternal and Child Health Hospital from March 2019 to October 2020 were collected as the observation group,and 60 cases of healthy children in the same period were included as the control group.Eosinophils were counted by flow cytometry with automatic blood analyzer,total serum IgE was measured by enzyme linked immunosorbent assay(ELISA),and FIB was detected by immunoturbidimetry with automatic coagulation analyzer.The combined diagnostic value of eosinophils,serum total IgE and FIB in children with HSP was compared and analyzed.Results The results of flow cytometry showed that the level of eosinophils in the observation group was significantly higher than that in the control group[(4.85±0.92)vs(2.88±0.34),t=8.33,P<0.05].Compared with the control group,the levels of FIB and D-D in the observation group were significantly higher[(2.32±0.59)g/L vs(3.82±0.87)g/L,(328.95±61.21)ug/L vs(562.62±65.92)ug/L,t values were 8.62 and 9.32 respectively,both P values<0.05].The sensitivity of eosinophils,total serum IgE and FIB in the diagnosis of HSP was 72.19%,90.24%and 75.21%respectively,and the specificity was 89.32%,81.19%and 65.38%respectively.The sensitivity and specificity of the combined diagnosis of eosinophils,total serum IgE and FIB in the diagnosis of HSP were 91.28%and 90.77%respectively.Conclusion Eosinophils combined with serum total IgE and FIB have high diagnostic efficacy in children with HSP.