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探讨免疫球蛋白 A 血管炎患者胃肠道受累的预测因素。

Exploring the predictive factors in the gastrointestinal involvement of patients with immunoglobulin A vasculitis.

机构信息

Department of Pediatrics, Department of Pediatric Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye.

出版信息

Turk J Pediatr. 2024 Nov 16;66(5):599-607. doi: 10.24953/turkjpediatr.2024.4797.

Abstract

BACKGROUND

Immunoglobulin A vasculitis (IgAV), the most common systemic vasculitis in children, typically presents with gastrointestinal (GI) symptoms in about half of cases. This study aimed to analyze the clinical and laboratory findings of patients with IgAV regarding GI involvement.

METHODS

We compared the GI involvement data of the patients diagnosed with IgAV.

RESULTS

Of the 210 patients (60.5% female and 39.5% male), 101 had GI involvement, with abdominal pain being the predominant symptom (n=98). White blood cell, neutrophil, monocyte, and platelet counts, C-reactive protein, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were significantly elevated in patients with GI involvement (p<0.001, p<0.001, p=0.01, p=0.005, p=0.002, p<0.001, p=0.03, p=0.001, p<0.001, p<0.001, respectively). The cutoff values for SII (>1035.7), SIRI (>1.65), NLR (>2.73), and MLR (>0.28) were determined, yielding respective sensitivities of 46%, 59%, 47%, and 53%, specificities of 83.1%, 69.1%, 81.3%, and 71.9%. Corresponding areas under the curve were 0.658, 0.668, 0.649, and 0.634, respectively (all p<0.001).

CONCLUSION

Although IgAV is a self-limiting disease, GI involvement can lead to serious consequences. Systemic inflammatory indices such as SII and SIRI may be indicative in identifying patients with GI involvement.

摘要

背景

免疫球蛋白 A 血管炎(IgAV)是儿童最常见的系统性血管炎,约半数病例有胃肠道(GI)症状。本研究旨在分析 IgAV 患者 GI 受累的临床和实验室发现。

方法

我们比较了诊断为 IgAV 的患者的 GI 受累数据。

结果

210 例患者中(60.5%为女性,39.5%为男性),101 例有 GI 受累,腹痛是主要症状(n=98)。白细胞、中性粒细胞、单核细胞和血小板计数、C 反应蛋白、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)、系统免疫炎症指数(SII)和全身炎症反应指数(SIRI)在有 GI 受累的患者中显著升高(p<0.001,p<0.001,p=0.01,p=0.005,p=0.002,p<0.001,p=0.03,p=0.001,p<0.001,p<0.001,分别)。确定了 SII(>1035.7)、SIRI(>1.65)、NLR(>2.73)和 MLR(>0.28)的截断值,其敏感性分别为 46%、59%、47%和 53%,特异性分别为 83.1%、69.1%、81.3%和 71.9%。相应的曲线下面积分别为 0.658、0.668、0.649 和 0.634(均 p<0.001)。

结论

虽然 IgAV 是一种自限性疾病,但 GI 受累可导致严重后果。SII 和 SIRI 等全身炎症指数可能有助于识别有 GI 受累的患者。

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