过敏性紫癜患儿急性期血清白介素-33与抗内皮细胞抗体-IgA、抗心磷脂抗体-IgA相关性分析

摘要

Objectives To explore the changes of serum interleukin-33 (IL-33), IgA anti-endothelial cell antibodies (AECA) and IgA anticardiolipin antibodies (ACA) in acute stage of Henoch-Sch?nlein purpura (HSP) in children and its clinical signiif-cance. Methods Thirty-seven children with acute HSP admitted to hospital were selected from Nov.2012 to Jan.2013. Twenty healthy children were selected as healthy controls. The serum levels of IL-33 were measured by double anti-body sandwich en-zyme-linked immunosorbent assay (ELISA) and the serum levels of AECA-IgA and ACA-IgA were detected by double antigen sandwich ELISA. Results Serum levels of IL-33, AECA-IgA and ACA-IgA in patients with acute HSP were signiifcantly higher than those in healthy controls (P<0.001). According to different clinical types, the serum levels of IL-33, AECA-IgA and ACA-IgA were signiifcantly higher in mixed-type HSP (with joint involvement and gastrointestinal symptoms and/or kidney damage) than those in HSP patients with only joint, abdomen or renal involvement (P<0.05). Serum levels of IL-33 in acute stage of HSP had a positive correlation with AECA-IgA (r=0.752, P<0.001) and ACA-IgA (r=0.788, P<0.001). Conclusions The immune pathological injury in vessels caused by the interaction of IL-33, AECA-IgA and ACA-IgA may be the important pathogenesis of HSP, which may provide a clue for the early diagnosis and treatment for HSP.%目的探讨不同临床类型过敏性紫癜（HSP）患儿急性期血清白介素-33（IL-33）、抗内皮细胞抗体IgA（AECA-IgA）、抗心磷脂抗体IgA（ACA-IgA）水平变化及其临床意义。方法选取2012年11月-2013年1月住院的HSP急性期患儿37例，健康儿童20例作为研究对象；采用双抗体夹心ELISA法测定血清IL-33水平，双抗原夹心ELISA法测定血清AECA-IgA、ACA-IgA水平并进行比较。结果 HSP患儿急性期血清IL-33、AECA-IgA、ACA-IgA的水平较健康儿童明显升高，差异均有统计学意义（P均<0.001）；混合型HSP患儿[除累及关节外，合并胃肠症状和（或）肾脏受损]血清IL-33、AECA-IgA、ACA-IgA水平与关节型、腹型和肾型相比较，差异均有统计学意义（P均<0.05）；急性期HSP患儿血清IL-33与AECA-IgA、ACA-IgA水平呈正相关（r=0.752、0.788，P均<0.001）。结论 IL-33、AECA-IgA、ACA-IgA相互作用所致血管免疫病理损伤，可能是HSP发病的重要因素，可为HSP的早期诊断和治疗提供线索。