B淋巴细胞激活因子表达水平在儿童特发性血小板减少性紫癜诊断及预后判断中的意义

摘要

Objective To study the value of B-cell activating factor (BAFF) expression levels in the diagnosis and prog-nosis of children with idiopathic thrombocytopenic purpura. Methods Children with idiopathic thrombocytopenic purpura (ITP) admitted to our hospital from September 2011 to September 2013 were enrolled in observation group, and healthy check-up chil-dren during the same period were enrolled as controls. The serum levels of B-cell activating factor, platelet antibodies (PAIgG, PAIgM, PAIgA) and platelet count were detected, and curative effect in children with ITP was observed. Results The BAFF, PAIgG, PAIgM and PAIgA levels were higher and platelet count were less in both acute and chronic ITP children than those in normal controls. The difference was signiifcant (P<0.05). The results of linear regression analysis indicated that BAFF levels were positively correlated with PAIgG, PAIgM and PAIgA levels (β=1.87~2.25, P<0.05), and were negatively correlated with platelet count (β=-2.42, P<0.05). Meanwhile, BAFF levels were negatively correlated with curative effect in ITP children (β=-1.88, P<0.05). When the value of BAFF was 1.35, the sensitivity for predicting effective treatment was 0.84 and the speciifcity was 0.75. The area under the ROC curve was 0.85 (95%CI:0.73~0.98, P=0.000). Conclusions The serum BAFF expression was increased and closely related to the level of antiplatelet antibody, platelet count and treatment effect in ITP children, and therefore, was a good indicator for the diagnosis and prognosis of ITP.%目的：研究B淋巴细胞激活因子(BAFF)表达水平在儿童特发性血小板减少性紫癜(ITP)诊断及预后中的应用价值。方法将2011年9月—2013年9月期间收治的初诊ITP患儿纳入研究组，同期健康体检儿童纳入对照组，检测两组对象血清中BAFF、抗血小板抗体PAIgG、PAIgM、PAIgA水平及血小板计数，观察治疗效果。结果急性型和慢性型ITP患儿外周血BAFF、PAIgG、PAIgM、PAIgA含量均高于对照组，PLT计数少于对照组，差异均有统计学意义(P均<0.05)。直线回归分析结果提示，BAFF含量与PAIgG、PAIgM、PAIgA的含量呈正相关(β=1.87~2.25，P均<0.05)，与血小板计数呈负相关(β=−2.42，P<0.05)；同时BAFF含量与疗效呈负相关(β=−1.88，P<0.05)。当BAFF取值为1.35时，其诊断治疗有反应的灵敏度为0.84，特异度为0.75；ROC曲线下面积AUC为0.85(95%CI：0.73~0.98，P=0.000)。结论 ITP患儿血清中BAFF表达量增加，且与抗血小板抗体、血小板计数以及治疗效果具有良好的相关性，可作为诊断疾病和判断预后的良好指标。