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[不同生物标志物在儿童过敏性紫癜诊断中的价值]

[Values of different biomarkers for diagnosis of Henoch-Schönlein purpura in children].

作者信息

Mu Yun, Sun Chao, Wang Liang, Meng Dong-Mei, Sun Xu-Guo

机构信息

Department of Medical Laboratory, Tianjin Childrenγs Hospital, Tianjin 300074, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2015 Sep;17(9):918-21.

Abstract

OBJECTIVE

To screen biomarkers which can be used as an auxiliary method in the diagnosis of Henoch-Schönlein purpura (HSP) and to evaluate their diagnostic values by receiver operating characteristic (ROC) curve analysis.

METHODS

A total of 127 children diagnosed with HSP between April 2012 and March 2014 were included in the HSP group and an equal number of healthy children were included in the control group. Twelve parameters, i.e., serum amyloid protein A (SAA), interleukin-6 (IL-6), immunoglobulins (IgA, IgG, IgM, and IgE), C-reactive protein (CRP), white blood cell (WBC) count, complements C3 and C4, anti-streptolysin O, and ferritin, were analyzed. The values of the screened biomarkers for diagnosis of HSP were assessed by ROC curve analysis.

RESULTS

The HSP group had significantly higher levels of SAA, IL-6, CRP, WBC, IgA, and IgM than the control group (P<0.05). The areas under the ROC curve of SAA, IL-6, WBC, IgA, and IgM for the diagnosis of HSP were higher than 0.7 (P<0.05). The optimal cut-off values of SAA, IgA, IgM, WBC, and IL-6 for the diagnosis of HSP were 3.035 μg/mL, 1579.5 mg/L, 922.5 mg/L, 8.850 × 10⁹/L, and 7.035 pg/mL, respectively; the corresponding sensitivities of the optimal cut-off values for the diagnosis of HSP were 95.1%, 75.6%, 72.3%, 78.0%, and 63.4%, respectively, and the corresponding specificities were 90.2%, 85.4%, 82.4%, 70.7%, and 80.5%, respectively.

CONCLUSIONS

SAA, IgA, IgM, WBC, and IL-6 are valuable biomarkers for clinical diagnosis of HSP and among them SAA seems to be the best one.

摘要

目的

筛选可作为过敏性紫癜(HSP)诊断辅助方法的生物标志物,并通过受试者工作特征(ROC)曲线分析评估其诊断价值。

方法

2012年4月至2014年3月期间共纳入127例诊断为HSP的儿童作为HSP组,纳入同等数量的健康儿童作为对照组。分析12项指标,即血清淀粉样蛋白A(SAA)、白细胞介素-6(IL-6)、免疫球蛋白(IgA、IgG、IgM和IgE)、C反应蛋白(CRP)、白细胞(WBC)计数、补体C3和C4、抗链球菌溶血素O以及铁蛋白。通过ROC曲线分析评估筛选出的生物标志物对HSP诊断的价值。

结果

HSP组的SAA、IL-6、CRP、WBC、IgA和IgM水平显著高于对照组(P<0.05)。SAA、IL-6、WBC、IgA和IgM诊断HSP的ROC曲线下面积均高于0.7(P<0.05)。SAA、IgA、IgM、WBC和IL-6诊断HSP的最佳截断值分别为3.035μg/mL、1579.5mg/L、922.5mg/L、8.850×10⁹/L和7.035pg/mL;这些最佳截断值诊断HSP的相应敏感度分别为95.1%、75.6%、72.3%、78.0%和63.4%,相应特异度分别为90.2%、85.4%、82.4%、70.7%和80.5%。

结论

SAA、IgA、IgM、WBC和IL-6是HSP临床诊断中有价值的生物标志物,其中SAA似乎是最佳标志物。

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