摘要
目的 探讨过敏性紫癜患儿滤泡辅助性T细胞(Tfh)及其亚群水平变化的临床意义。方法 选择2020年8月至2022年1月西安医学院第一附属医院收治的114例过敏性紫癜患儿作为观察组,另选择同期于该院进行体检的57例健康儿童作为对照组。检测并比较两组Tfh(CD3~+CD4~+CXCR5~+)细胞及其亚群Tfh1(CCR6-CXCR3+Tfh)、Tfh2(CCR6-CXCR3-Tfh)、Tfh17(CCR6+CXCR3-Tfh)细胞水平;采用Pearson相关分析Tfh及其亚群水平与过敏性紫癜患儿紫癜症状的相关性;观察组患儿均进行随访,根据预后是否良好分为预后良好组和预后不良组,比较两组Tfh及其亚群水平,并绘制受试者工作特征(ROC)曲线分析Tfh及其亚群水平对过敏性紫癜患儿预后的评估价值。结果 观察组Tfh、Tfh2水平均高于对照组,Tfh1水平低于对照组,差异均有统计学意义(P<0.05),但两组Tfh17水平比较,差异无统计学意义(P>0.05)。紫癜症状评分>4分的患儿Tfh、Tfh2水平高于紫癜症状评分≤4分的患儿,Tfh1水平低于紫癜症状评分≤4分的患儿,差异均有统计学意义(P<0.05),但不同紫癜症状评分患儿的Tfh17水平比较,差异无统计学意义(P>0.05)。Pearson相关分析结果显示,过敏性紫癜患儿Tfh、Tfh2水平与紫癜症状评分呈正相关(P<0.05),Tfh1水平与紫癜症状评分呈负相关(P<0.05),Tfh17水平与紫癜症状评分无明显相关性(P>0.05)。预后不良组Tfh、Tfh2水平均高于预后良好组,Tfh1水平低于预后良好组,差异均有统计学意义(P<0.05),但两组Tfh17水平比较,差异无统计学意义(P>0.05)。ROC曲线分析结果显示,Tfh、Tfh1、Tfh2评估过敏性紫癜患儿预后不良的曲线下面积分别为0.894、0.849、0.783,灵敏度分别为88.24%、85.29%、76.47%,特异度分别为71.25%、70.00%、70.83%。结论 过敏性紫癜患儿Tfh、Tfh2水平较高,Tfh1水平较低,Tfh17水平正常,动态监测Tfh、Tfh1、Tfh2水平有利于评估过敏性紫癜患儿病情严重程度及预后。
Objective To investigate the clinical significance of the changes in follicular helper T cell(Tfh)and its subgroups levels in children with allergic purpura.Methods A total of 114 children with allergic purpura admitted to the First Affiliated Hospital of Xi′an Medical University from August 2020 to January 2022 were selected as the observation group,and 57 cases of healthy children who underwent physical examination in the hospital during the same period were selected as the control group.The cell levels of Tfh(CD3+CD4+CXCR5+)cells and its subgroups Tfh1(CCR6-CXCR3+Tfh),Tfh2(CCR6-CXCR3-Tfh)and Tfh17(CCR6+CXCR3-Tfh)were detected and compared in both groups.The correlation between Tfh cells and its subgroups with purpura symptoms in children with allergic purpura was analyzed by Pearson correlation analysis.All the children in the observation group were followed up,and subdivided into the good prognosis group and the poor prognosis group according to whether the prognosis was good or not.Tfh and its subgroups levels in both groups were compared,and ROC curve was drawn to analyze the evaluation value of Tfh and its subgroups levels on the prognosis of children with allergic purpura.Results The Tfh and Tfh2 levels in the observation group were higher than those in the control group,and the Tfh1 level was lower than that in the control group,with statistically significant difference(P<0.05),but there was no significant difference in Tfh17 level between the two groups(P>0.05).Tfh and Tfh2 levels in children with purpura symptom score>4 points were higher than those in childern with purpura symptom score≤4 points,and Tfh1 level was lower than that in children with purpura symptom score≤4 points,with statistically significant difference(P<0.05),but there was no significant difference in Tfh17 between children with purpura symptom score>4 points and purpura symptom score≤4 points(P>0.05).Pearson correlation analysis showed that Tfh and Tfh2 levels were positively correlated with purpura symptom scores(P<0.05),Tfh
作者
白跳艳
BAI Tiaoyan(Department of Laboratory,the First Affiliated Hospital of Xi′an Medical University,Xi′an,Shaanxi 710016,China)
出处
《检验医学与临床》
CAS
2023年第15期2243-2246,共4页
Laboratory Medicine and Clinic
关键词
过敏性紫癜
滤泡辅助性T细胞
紫癜症状
预后
allergic purpura
follicular helper T cells
purpura symptoms
prognosis
