血小板衍生细胞外囊泡在儿童IgA血管炎肾损伤患者中的表达及意义

The expression and significance of the extracellular microcapsules of platelet sources in patients with IgA vasculitis renal injuries

目的研究血小板衍生细胞外囊泡(PEVs)与儿童免疫球蛋白A血管炎肾损伤(IgAVN)的相关性。方法采用回顾性队列研究方法,纳入2017年6月至2020年6月于该院儿科住院的92例免疫球蛋白A血管炎(IgAV)患儿作为研究对象(观察组),其中包括42例IgAVN患儿(IgAVN组)和50例无肾损伤的IgAV患儿(IgAV组)。另纳入性别、年龄匹配的健康儿童50例作为健康对照组。采用流式细胞术检测PEVs。相关分析用于评价IgAVN患儿PEVs水平与临床指标的相关性。研究队列随访12周,采用Poisson回归分析PEVs水平与迟发IgAVN、慢性IgAVN发生风险的相关性。结果观察组血浆PEVs水平为(296.94±24.37)个/μL,高于健康对照组的(225.67±34.13)个/μL,差异有统计学意义(P<0.001)。相关分析显示,血浆PEVs水平与IgAVN患儿便潜血阳性百分比、总免疫球蛋白E、超敏C反应蛋白、白细胞计数、红细胞沉降率、血浆D二聚体水平呈正相关(P<0.05)。Poisson回归显示,基线血浆PEVs水平与迟发IgAVN发生风险有关(RR=1.22,P=0.026),而与慢性IgAVN风险无明显相关性(RR=1.14,P=0.083)。结论PEVs水平与IgAVN病情活动程度和消化道损伤有关,也是迟发性IgAVN的预测指标。

Objective To study the correlation of an extracellular microcapsule(PEVs)of platelet sources and children’s immunoglobulin A vasculitis kidney injury(IgAVN).Methods The retrospective queue research method was adopted,and 92 cases of immunoglobulin A vasculitis(IgAV)were hospitalized(observation group)in the hospital from June 2017 to June 2020 as the research object.These included 42 children with IgAVN(IgAVN group)and 50 children with no kidney injury(IgAV group).Fifty healthy children were also included in the control group.PEVs was measured by flow cytometry.Related analysis was used to evaluate the correlation between PEVs levels and clinical indicators.The research queue was followed up for 12 weeks and Poisson regression used to analysis association between PEVs level with late IgAVN and chronic IgAVN risks.Results The PEVs level of the observation group was(296.94±24.37)counts/μL,which was higher than the(225.67±34.13)counts/μL of the control group.The difference was statistically significant(P<0.001).Related analysis showed that PEVs levels were positively correlated with children with IgAVN children with blood,IgE,ultra sensitivity C reactive protein,white blood cells,red blood cell settlement rate,and plasma D-dimer(P<0.05).Poisson regression showed that the level of baseline plasma PEVs was related to the risk of late IgAVN(RR=1.22,P=0.026),and was no related with chronic IgAVN risk(RR=1.14,P=0.083).Conclusion The level of PEVs is related to the degree of disease activity and digestive tract damage,and it is also a prediction indicator of late IgAVN.