NAG/UCr、CRP及补体C3、C4与过敏性紫癜患儿并发肾炎的关系

Relationship between NAG/UCr,CRP,C3,C4 and nephritis in children with Henoch⁃schonlein purpura

目的探讨N-乙酰-β-D-氨基葡萄糖苷酶/尿肌酐(NAG/UCr)、C-反应蛋白(CRP)及补体C3、C4与过敏性紫癜(HSP)患儿并发肾炎的关系。方法纳入2020年7月至2021年4月就诊于安徽儿童医院的HSP患儿142例,根据患儿是否并发肾炎分成HSP组(n=97)和过敏性紫癜性肾炎组(HSPN,n=45)。比较两组患儿的临床资料和NAG/UCr、CRP及补体C3、C4水平,采用多因素Logistic回归分析HSP患儿并发肾炎的影响因素,受试者工作特性曲线(ROC)分析D-二聚体、UA联合补体C3、C4水平对HSP患儿并发肾炎的预测价值。结果HSP和HSPN组患儿的年龄、紫癜反复次数、皮疹持续时间、PLT、WBC、RDW、NEU、DD、尿蛋白量、NAG/UCr、CRP及补体C3、C4等比较,差异均有统计学意义(t=15.431、2.828、3.199、2.644、7.747、27.408、15.806、7.992、3.133、4.609、3.118,χ^(2)=9.988、8.715,P<0.05);多因素Logistic回归显示,年龄、紫癜反复次数、皮疹持续时间、NAG/UCr、CRP及补体C3、C4是HSP患儿并发肾炎的独立危险因素(P<0.05)。ROC曲线显示,NAG/UCr、CRP与补体C3、C4及四者联合检测曲线下面积为0.793、0.701、0.784、0.713、0.896。结论NAG/UCr、CRP及补体C3、C4与HSP患儿并发肾炎密切相关,NAG/UCr、CRP及补体C3、C4联合检测对HSP患儿并发肾炎有良好的预测价值。

Objective To investigate the relationship between n⁃acetyl⁃β⁃D⁃glucosaminidase/urinary creatinine(NAG/UCr),C⁃reactive protein(CRP)and complement C3,C4 and nephritis in children with Henoch⁃schonlein purpura(HSP).Methods A total of 142 children with HSP admitted to Anhui Children􀆳s Hospital from July 2020 to April 2021 were included,and they were divided into the HSP(n=97)group and HSPN(n=45)group according to whether the children were complicated with nephritis.The clinical data and the levels of NAG/UCr,CRP and complement C3 and C4 were compared between the two groups.Multiple Logistic regression was used to analyze the influencing factors of nephritis in children with HSP.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of D⁃dimer,UA combined with complement C3 and C4 in children with HSP complicated nephritis.Results There were statistically significant differences between HSP and HSPN groups in age,repeated times of purpura,rash duration,PLT,WBC,RDW,NEU,DD,urine protein,NAG/UCr,CRP,and complement C3 and C4(t=15.431,2.828,3.199,2.644,7.747,27.408,15.806,7.992,3.133,4.609,3.118,χ^(2)=9.988,8.715,P<0.05).Multiple Logistic regression showed that age,frequency of purpura recurrence,duration of rash,NAG/UCr,CRP and complement C3 and C4 were independent risk factors for patients with HSP complicated nephritis(P<0.05).The ROC curve showed that the areas under the curve of NAG/UCr,CRP and complement C3,C4 and the four combined detection curves were 0.793,0.701,0.784,0.713 and 0.896.Conclusion NAG/UCr,CRP and complement C3 and C4 are closely related to nephritis in children with HSP,and the combined detection of NAG/UCr,CRP and complement C3 and C4 has a good predictive value for children with HSP complicated nephritis.