[全血细胞计数和炎症标志物对过敏性紫癜患儿复发风险的预测价值]
[Predictive Value of Complete Blood Count and Inflammation Marker on Risk of Recurrence in Children with Henoch-Schönlein Purpura].
作者信息
Jiang Ya-Jing, Song Dan-Yang, Li Jin-Ling
机构信息
Department of Pediatrics, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China. E-mail:
Department of Pediatrics, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China.
出版信息
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Jun;31(3):837-842. doi: 10.19746/j.cnki.issn.1009-2137.2023.03.032.
OBJECTIVE
To investigate the predictive value of complete blood count (CBC) and inflammation marker on the recurrence risk in children with Henoch-Schönlein purpura (HSP).
METHODS
One hundred and thirty-three children with HSP admitted to Cangzhou Central Hospital from February 2017 to March 2019 were enrolled. The clinical data of the children were collected, at the time of admission CBC and C-reactive protein (CRP) were detected. After discharge, the children were followed up for 1 year, the clinical data of children with and without recurrence were compared, and multivariate logistic regression was used to analyze the risk factors affecting HSP recurrence. Receiver operating characteristic (ROC) curve should be drawn and the predictive value of CBC and CRP on HSP recurrence should be analyzed.
RESULTS
In the follow-up of 133 children, 8 cases were lost and 39 cases recurred, with a recurrence rate of 31.20% (39/125). The age, skin rash duration, proportion of renal damage at the initial onset, percentage of neutrophils, percentage of lymphocytes, platelet count (PLT), mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), MPV/PLT ratio (MPR), and CRP level of patients with recurrence were statistically different from those without recurrence ( <0.05). Multivariate logistic regression analysis showed that long skin rash duration, renal damage at the initial onset, increased PLR, high PLT, increased MPV and elevated CRP level were independent risk factors for recurrence in children with HSP ( <0.05). The ROC curve analysis showed that the area under the curve (AUC) of the combination of the four blood and inflammation marker (PLT, MPV, PLR and CPR) in the early prediction of HSP recurrence was 0.898, which was higher than the initial renal damage (AUC=0.687) and persistent skin rash time (AUC=0.708), with a sensitivity of 84.62% and a specificity of 83.72%.
CONCLUSION
Observation of CBC and CPR can predict the risk of HSP recurrence early and guide early clinical intervention.
目的
探讨全血细胞计数（CBC）及炎症标志物对过敏性紫癜（HSP）患儿复发风险的预测价值。
方法
选取2017年2月至2019年3月在沧州市中心医院收治的133例HSP患儿。收集患儿的临床资料，入院时检测CBC及C反应蛋白（CRP）。出院后对患儿进行1年随访，比较复发患儿与未复发患儿的临床资料，并采用多因素logistic回归分析影响HSP复发的危险因素。绘制受试者工作特征（ROC）曲线，分析CBC及CRP对HSP复发的预测价值。
结果
对133例患儿进行随访，失访8例，复发39例，复发率为31.20%（39/125）。复发患儿与未复发患儿的年龄、皮疹持续时间、初发时肾脏损害比例、中性粒细胞百分比、淋巴细胞百分比、血小板计数（PLT）、平均血小板体积（MPV）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、MPV/PLT比值（MPR）及CRP水平比较，差异有统计学意义（<0.05）。多因素logistic回归分析显示，皮疹持续时间长、初发时肾脏损害、PLR升高、PLT升高、MPV升高及CRP水平升高是HSP患儿复发的独立危险因素（<0.05）。ROC曲线分析显示，四项血液及炎症标志物（PLT、MPV、PLR及CPR）联合预测HSP复发的曲线下面积（AUC）为0.898，高于初发时肾脏损害（AUC=0.687）及皮疹持续时间（AUC=0.708），敏感度为84.62%，特异度为83.72%。
结论
观察CBC及CPR可早期预测HSP复发风险，指导临床早期干预。
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