Clin Lab. 2022 Aug 1;68(8). doi: 10.7754/Clin.Lab.2021.211030.
The aim was to explore the correlations of leukotriene B4 (LTB4) and 25-hydroxyvitamin D3 [25(OH)D3] levels with disease severity in children with Henoch-Schonlein purpura (HSP).
A total of 260 HSP children admitted from January 2017 to December 2018 were selected, and 60 healthy children physically examined in the same period were enrolled as controls. The results of general laboratory tests and expression levels of leukotriene B4 (LTB4) and 25-hydroxyvitamin D3 [25(OH)D3] were compared. The correlations of LTB4 and 25(OH)D3 with immunoglobulin A (IgA) were statistically analyzed, and the expression levels of LTB4 and 25(OH)D3 were compared between Henoch-Schonlein purpura nephritis (HSPN) group and non-Henoch-Schonlein purpura nephritis (NHSPN) group. The optimal cutoff values of LTB4 and 25(OH)D3 to predict HSP were analyzed by receiver operating characteristic (ROC) curves, based on which they were divided into low-, intermediate-, and high-risk groups. The length of hospital stay and recurrence rate within 6 months were compared.
The levels of white blood cell count, platelets, C-reactive protein, IgA, IgM, IgE, complement C3, and LTB4 were significantly higher and 25(OH)D3 was lower in HSP group than those in control group (p < 0.05). IgA, LTB4, and 25(OH)D3 levels were independent risk factors for HSP (p < 0.05). LTB4 was positively correlated with IgA (p < 0.05), and 25(OH)D3 was negatively correlated with IgA (p < 0.05). LTB4 level was significantly higher and 25(OH)D3 level was lower in HSPN group than those in NHSPN group (p < 0.05). The optimal cutoff values of LTB4 and 25(OH)D3 were 27.82 pg/mL and 22.10 ng/mL, respectively, the length of hospital stay gradually increased in low-, intermediate-, and high-risk groups, and the recurrence rates within 6 months were 14.2%, 31.5%, and 39.6%, respectively (p < 0.05).
LTB4 level increases and 25(OH)D3 level decreases in children with HSP, and the expression levels are significantly correlated with disease severity, suggesting predictive values for prognosis.
本研究旨在探讨白三烯 B4(LTB4)和 25-羟维生素 D3 [25(OH)D3]水平与儿童过敏性紫癜(HSP)严重程度的相关性。
选择 2017 年 1 月至 2018 年 12 月期间入院的 260 例 HSP 患儿,并纳入同期体检的 60 例健康儿童作为对照组。比较两组一般实验室检查结果和 LTB4、25-羟维生素 D3 [25(OH)D3]的表达水平。统计分析 LTB4 和 25(OH)D3 与免疫球蛋白 A(IgA)的相关性,并比较 HSP 肾炎(HSPN)组和非 HSP 肾炎(NHSPN)组的 LTB4 和 25(OH)D3 表达水平。根据受试者工作特征(ROC)曲线分析 LTB4 和 25(OH)D3 预测 HSP 的最佳截断值,并据此将其分为低危组、中危组和高危组。比较三组患儿的住院时间和 6 个月内的复发率。
与对照组相比,HSP 组白细胞计数、血小板计数、C 反应蛋白、IgA、IgM、IgE、补体 C3 和 LTB4 水平明显升高,25(OH)D3 水平明显降低(p<0.05)。IgA、LTB4 和 25(OH)D3 是 HSP 的独立危险因素(p<0.05)。LTB4 与 IgA 呈正相关(p<0.05),25(OH)D3 与 IgA 呈负相关(p<0.05)。与 NHSPN 组相比,HSPN 组 LTB4 水平显著升高,25(OH)D3 水平显著降低(p<0.05)。LTB4 和 25(OH)D3 的最佳截断值分别为 27.82pg/ml 和 22.10ng/ml,低、中、高危组患儿的住院时间逐渐延长,6 个月内的复发率分别为 14.2%、31.5%和 39.6%(p<0.05)。
HSP 患儿 LTB4 水平升高,25(OH)D3 水平降低,表达水平与疾病严重程度显著相关,提示对预后有预测价值。