儿童过敏性紫癜患者血清IL-21、TGF-β、TNF-α和IgA1的变化及其意义

摘要

目的：观察儿童过敏性紫癜(HSP)患者血清白细胞介素-21(IL-21)、转化生长因子-β(TGF-β)、肿瘤坏死因子-α(TNF-α)和免疫球蛋白A1(IgA1)的变化及意义。方法收集我院儿科2013年6月至2015年8月收治的HSP急性期患儿200例，按照尿常规结果分为HSP组(n=109)和紫癜性肾炎(HSPN)组(n=91)。选取同时期在我院健康体检中心体检的20例健康儿童作为对照组。检测并分析三组儿童的血清IL-21、TGF-β、TNF-α、免疫球蛋白及补体水平变化，比较各组间IgA/C3值变化，并对HSP组患儿血清因子进行Pearson相关分析。结果 HSP组和HSPN组患儿的IL-21水平显著低于对照组，TGF-β、TNF-α、IgA1、IgA水平和IgA/C3显著高于对照组，且HSPN组TNF-α、IgA水平和IgA/C3显著高于HSP组，差异均有统计学意义(P>0.05或P<0.01)，而IgG、IgM、C3和C4分别与对照组比较差异均无统计学意义(P>0.05)；Pearson相关性分析结果显示，IL-21与TGF-β、TNF-α、IgA1、IgA及IgA/C3均无相关性(P>0.05)，TGF-β与TNF-α呈正相关(P<0.05)，IgA1与IgA、IgA/C3均呈正相关(P<0.05)。结论检测血清IL-21、TGF-β、TNF-α及IgA1有助于明确儿童过敏性紫癜的发生发展，及早采取措施，可防止病情继续恶化形成紫癜性肾炎。%Objective To discuss the relationship between the change of interleukin-21 (IL-21), transforma-tion growth factor-β (TGF-β), tumor necrosis factor-α (TNF-α), immunoglobulin protein A1 (IgA1) in children with Henoch-Schonlein purpura (HSP). Methods A total of 200 cases of children with acute stage of HSP, who admitted to Department of Pediatrics of our hospital from June 2013 to August 2015, were collected and divided into HSP group (n=109) and HSPN (Henoch-Schonlein purpura nephritis) group (n=91) according to the routine urine results. At the same time, twenty healthy children in the health examination center of our hospital were selected as the control group. The changes of serum IL-21, TGF-β, TNF-α, immunoglobulin and complement levels were detected and analyzed in the three groups, and the IgA/C3 values of the three groups were compared. Pearson correlation analysis was used to analyze serum factors in the HSP group. Results The IL-21 level in the HSP group and HSPN group were significantly lower than those in the control group, while the levels of TGF-β, TNF-α, IgA1, IgA and IgA/C3 in the HSP group and HSPN group were significantly higher than those in the control group. The levels of TN-α, IgA and IgA/C3 in the HSPN group were significantly higher than those in the HSP group. The differences had statistical significance (P<0.05 or P<0.01). However, the levels of IgG, IgM, C3 and C4 in the HSP group and HSPN group showed no statistically significant differ-ence compared with those in the control group (P>0.05). Pearson correlation analysis showed that there was no correla-tion among IL-21 and TGF-β, TNF-α, IgA1, IgA, IgA/C3 (P>0.05);TNF-αwas positively correlated with TGF-β(P<0.05), and IgA1 was positively correlated with IgA and IgA/C3 (P<0.05). Conclusion The detection of the levels of IL-21, TGF-β, TNF-αand IgA1 can help to clear the occurrence of Henoch-Schonlein purpura and take measures to pre-vent the disease from deteriorating into Henoch-Schonlein purpura nephritis.