血清25羟维生素D在儿童紫癜性肾炎中的早期预测作用

潘华; 邓芳

doi:10.16766/j.cnki.issn.1674-4152.002986

血清25羟维生素D在儿童紫癜性肾炎中的早期预测作用

doi: 10.16766/j.cnki.issn.1674-4152.002986

潘华¹,
邓芳^2, ,

1.
宿州市立医院儿童肾脏风湿科，安徽宿州 234000
2.
安徽省立儿童医院儿童肾脏科，安徽合肥 230051

基金项目:

安徽省自然科学基金项目 2108085MH262

详细信息

通讯作者:
邓芳，E-mail：dengfang@ahmu.edu.cn

中图分类号: R692.34 R554.6
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出版历程
- 收稿日期: 2022-09-22

Early prediction of serum 25-hydroxyvitamin D in children with Henoch-Schonlein purpura nephritis

PAN Hua¹,
DENG Fang^{2
, ,}

1.
Department of Kidney Rheumatology, Suzhou Municipal Hospital, Suzhou, Anhui 234000, China

摘要

摘要: 目的探讨血清25羟维生素D[25-(OH)D]对紫癜性肾炎(HSPN)的影响，并进一步揭示血清25-(OH)D对HSPN的早期诊断价值。方法选取2019年1月—2021年12月就诊于宿州市立医院儿科的102例过敏性紫癜(HSP)患儿作为病例组，其中HSPN组患儿31例，非HSPN组(NHSPN组)为71例；另选取同期就诊于该院门诊的94例健康体检儿童作为健康对照组。比较各组儿童血清25-(OH)D的情况；使用二元logistic回归分析方法分析血清25-(OH)D影响HSPN发生的风险；并采用受试者工作特征曲线分析血清25-(OH)D对HSPN的诊断价值。结果健康对照组血清25-(OH)D水平显著高于HSP组；HSPN组血清25-(OH)D水平显著低于NHSPN组及HSP组(均P < 0.01)。健康对照组儿童血清25-(OH)D升高，其发生HSP的风险将降低(OR=0.302, P < 0.001)；而HSP组儿童血清25-(OH)D降低, 其发生HSPN的风险将升高(OR=1.650, P < 0.001)。此外，区分HSP与HSPN患儿时，血清25-(OH)D的ROC曲线下面积为0.814，当截断值为23.34 ng/mL时，灵敏度和特异度分别为68.6%和87.1%。结论血清25-(OH)D水平的降低，可能是HSPN发生的危险因素，其在HSPN的早期发病中起预测作用。
- 25羟维生素D /
- 紫癜性肾炎 /
- 过敏性紫癜
Abstract: Objective To investigate the effect of serum 25 hydroxyvitamin D [25-(OH)D] on Henoch-Schonlein purpura nephritis (HSPN)and to determine the early diagnostic value of serum 25-(OH)D in HSPN. Methods A total of 102 cases of Henoch-Schonlein Purpura (HSP) children who were hospitalized in the Department of Pediatrics, Suzhou Municipal Hospital from January 2019 to December 2021 were selected as the case group, including 31 children in HSPN group and 71 children in Non Henoch-Schonlein purpura nephritis (NHSPN)group; 94 healthy children were selected as the healthy control group. The serum 25-(OH)D of children in each group was compared; The risk of serum 25-(OH)D affecting HSPN was analyzed by binary logistic regression analysis; The diagnostic value of serum 25-(OH)D for HSPN was analyzed by subject working characteristic curve. Results The level of serum 25-(OH)D in healthy control group was significantly higher than that in HSP group; The level of serum 25-(OH) D in HSPN group were significantly lower than that in the NHSPN group and the HSP group (both P < 0.01). When the serum 25-(OH) D of children in the healthy control group increased, the risk of HSP decreased (OR=0.302, P < 0.001); The serum 25-(OH) D of children in HSP group decreased; The risk of HSPN increased (OR=1.650, P < 0.001). In addition, the area under the ROC curve of serum 25-(OH)D was 0.814 for differentiating HSP from HSPN. Using a cut-off value was 23.34 ng/mL, the sensitivity and specificity were 68.6% and 87.1%, respectively. Conclusion Decreased serum 25-(OH)D level may be a risk factor for HSPN, It plays a predictive role in the early onset of HSPN.
- 25 hydroxyvitamin D /
- Henoch-Schonlein purpura nephritis /
- Henoch-Schonlein purpura
利益冲突 无

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图 1 血清25-(OH)D在区分HSP和HSPN患儿之间的ROC曲线

Figure 1. ROC curve of serum 25-(OH) D between HSP and HSPN children

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表 1 各组儿童一般资料比较

Table 1. Comparison of general data of each group

组别	例数	性别 (男/女，例)	年龄 (x±s，岁)	采血季节 (秋冬/春夏，例)
对照组	94	58/36	7.70±0.57	51/43
HSP组	102	69/33	7.65±0.71	47/55
NHSPN组	71	48/23	7.62±0.72	30/41
HSPN组	31	21/10	7.73±0.69	17/14
统计量		1.010^a	0.304^b	3.090^a
P值		0.799	0.823	0.378
注：^a 为χ²值，^b 为F值。

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表 2 各组儿童血清中25-(OH)D表达情况比较(x±s，ng/mL)

Table 2. Comparison of 25-(OH) D expression levels in sera of children in each group(x±s, ng/mL)

组别	例数	25-(OH)D
对照组	94	32.25±3.53
HSP组	102	23.67±3.31^a
NHSPN组	71	25.32±2.14^a
HSPN组	31	19.89±2.24^ab
F值		192.068
P值		< 0.001
注：对照组比较，^aP < 0.05；与HSP组比较，^bP < 0.05。

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表 3 血清25-(OH)D对HSP发病的二元logistic回归分析

Table 3. The Binary logistic regression analysis of serum 25-(OH) D on the incidence of HSP

变量	B	SE	Wald χ²	P值	OR(95% CI)
年龄	-0.606	0.625	0.942	0.332	0.546(0.160~1.855)
性别	-0.737	0.835	0.780	0.377	0.478(0.093~2.457)
季节	-0.687	0.756	0.854	0.356	0.513(0.136~1.987)
25-(OH)D	-1.198	0.215	31.057	< 0.001	0.302(0.198~0.460)
注：各变量赋值方法如下，年龄：以实际值赋值；性别：1=男，2=女；季节：1=秋冬季，2=春夏季；25-(OH)D：以实际值赋值。

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表 4 血清25-(OH)D影响HSP并发肾损伤的二元logistic回归分析

Table 4. The binary logistic regression analysis of the effect of serum 25-(OH) D on HSP complicated with renal injury

变量	B	SE	Wald χ²	P值	OR(95% CI)
年龄	0.085	0.378	0.050	0.822	1.089(0.519~2.284)
性别	-0.147	0.522	0.079	0.778	0.863(0.311~2.400)
季节	-0.236	0.765	0.097	0.870	0.924(0.456~2.132)
25-(OH)D	0.954	0.147	41.907	< 0.001	1.650(1.341~2.029)
注：各变量赋值方法如下，年龄：以实际值赋值；性别：男=1，女=2；季节：秋冬季=1，春夏季=2；25-(OH)D：以实际值赋值。

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