Purevdorj Narangerel, Mu Yun, Gu Yajun, Zheng Fang, Wang Ran, Yu Jinwei, Sun Xuguo
School of Medical Laboratory, Tianjin Medical University, No.1 Guangdong Road, Hexi District, Tianjin 300203, China.
Department of Clinical Laboratory, Tianjin Children's Hospital, 238 Longyan Road, Beichen District, Tianjin 300134, China.
Clin Biochem. 2018 Feb;52:167-170. doi: 10.1016/j.clinbiochem.2017.11.006. Epub 2017 Nov 10.
To explore a panel of serum biomarkers for laboratory diagnosis of pediatric Henoch-Schönlein purpura (HSP).
The blood white blood cells (WBC) and serum levels of serum amyloid A (SAA), interleukin 6 (IL-6), immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin E (IgE), C-reactive protein (CRP), complement component 3 (C3), complement component 4 (C4), and ASO (anti-streptolysin O) were detected in 127 patients with Henoch-Schonlein purpura (HSP), 110 cases of septicemia patients, and 121 healthy volunteers. The diagnostic ability of biomarkers selected from HSP and septicemia patients was analyzed by ROC curve. By designing the calculation model, the biomarker index was calculated for laboratory diagnosis of HSP and differential diagnosis between HSP and septicemia.
The levels of serum WBC, CRP, IL-6 and SAA in the septicemia patients were significantly higher than those in the control group (p<0.05). Compared with the healthy individuals, serum levels of WBC, CRP, IL-6, SAA, IgA and IgM were significantly increased in patients with HSP (p<0.05). The area under the curve (AUC) of SAA, IgA, IgM, WBC, IL-6, and CRP in the patients with HSP was 0.964, 0.855, 0.849, 0.787, 0.765, and 0.622, respectively. The values of SAA, IgA, IgM, WBC, IL-6, and CRP in septicemia patients were 0.700, 0.428, 0.689, 0.682, 0.891, and 0.853, respectively. Biomarker index=SAA+IgA/4000+IgM/4000×0.4CRPmean valueCRPi The biomarker index in HSP patients was significantly higher than that of the healthy controls. However, the biomarker index in septicemia patients was significantly lower than the control.
The biomarker index of HSP patients is higher than that of the control group. While in the infectious disease represented by septicemia, it is decreased. The detection of biomarker index could exclude the interference of infection as the auxiliary examination to HSP patients.
探索一组用于小儿过敏性紫癜（HSP）实验室诊断的血清生物标志物。
检测127例过敏性紫癜（HSP）患者、110例败血症患者及121名健康志愿者的血液白细胞（WBC）以及血清淀粉样蛋白A（SAA）、白细胞介素6（IL-6）、免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）、免疫球蛋白E（IgE）、C反应蛋白（CRP）、补体成分3（C3）、补体成分4（C4）和抗链球菌溶血素O（ASO）的血清水平。通过ROC曲线分析从HSP和败血症患者中筛选出的生物标志物的诊断能力。通过设计计算模型，计算生物标志物指数用于HSP的实验室诊断及HSP与败血症的鉴别诊断。
败血症患者的血清WBC、CRP、IL-6和SAA水平显著高于对照组（p<0.05）。与健康个体相比，HSP患者的血清WBC、CRP、IL-6、SAA、IgA和IgM水平显著升高（p<0.05）。HSP患者中SAA、IgA、IgM、WBC、IL-6和CRP的曲线下面积（AUC）分别为0.964、0.855、0.849、0.787、0.765和0.622。败血症患者中SAA、IgA、IgM、WBC、IL-6和CRP的值分别为0.700、0.428、0.689、0.682、0.891和0.853。生物标志物指数=SAA+IgA/4000+IgM/4000×0.4CRP平均值/CRPi HSP患者的生物标志物指数显著高于健康对照组。然而，败血症患者的生物标志物指数显著低于对照组。
HSP患者的生物标志物指数高于对照组。而在以败血症为代表的感染性疾病中，该指数降低。检测生物标志物指数可排除感染因素的干扰，作为HSP患者的辅助检查。
