摘要
目的探讨微生物感染与过敏性紫癜(HSP)发生风险的关系及免疫水平检测对HSP病原菌感染的诊断价值。方法于2017年6月-2020年10月我院收治的132例HSP患者为研究组,以及同时段100例体检合格者为对照组。比较两组受试者基线资料以及免疫表达水平,采用Logistic回归分析HSP发生感染的影响因素,采用ROC曲线评估免疫细胞失衡对HSP病原菌感染的诊断价值。结果132例HSP患者中并发感染者42例,共检测出54株病原菌,主要感染病原菌为溶血链球菌9株、表皮葡萄球菌7株、肺炎克雷伯菌7株。两组受试者血清IgA水平、家族史、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、感染比较差异有统计学意义(P<0.05)。Logistic回归分析显示,血清IgA水平、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、感染均是HSP发生的独立危险因素(P<0.05)。ROC曲线分析显示,CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)诊断HSP的曲线下面积(AUC)分别为0.746(95%CI:0.629~0.863)、0.788(95%CI:0.670~0.907)、0.862(95%CI:0.756~0.968),其中CD4+/CD8+的AUC高于CD4^(+)、CD8^(+)(P<0.05)。结论微生物感染以及免疫失衡是HSP发生的独立危险因素,其中CD4+/CD8+对于HSP病原菌感染具有良好的诊断价值。
Objective To explore the relationship between microbial infections and the risk of Henoch Schonlein purpura(HSP)and the diagnostic value of levels of immune factors and immune cells at detecting a pathogen causing HSP.Methods One hundred and thirty-two patients with HSP seen at this Hospital from June 2017 to October 2020 served as the study group,and 100 healthy people who underwent a physical examination at the same time served as the control group.Baseline data and levels of immune factors and immune cells in the two groups were compared.Logistic regression was used to analyze the factors influencing development of an infection causing HSP.The ROC curve was used to evaluate the diagnostic value of an immune cell imbalance at detecting a pathogen causing HSP.Results Of the 132 patients with HSP,42 had an infection.A total of 54 pathogens were detected.The main infectious pathogens were 9 strains of Streptococcus hemolyticus,7 strains of Staphylococcus epidermidis,and 7 strains of Klebsiella pneumoniae.There were significant differences in serum IgA levels,family history,levels of CD4^(+)and CD8^(+)cells and the ratio of CD4^(+)/CD8^(+)cells,and infection between the two groups(P<0.05).Logistic regression analysis indicated that serum IgA levels,levels of CD4^(+)and CD8^(+)cells and the ratio of CD4^(+)/CD8^(+)cells,and infection were all independent risk factors for HSP(P<0.05).ROC curve analysis indicated that the area under the curve for the level of CD4^(+)cells to diagnose HSP was 0.746(95%CI:0.629-0.863),that for the level of CD8^(+)cells was 0.788(95%CI:0.670-0.907),and that for the ratio of CD4^(+)/CD8^(+)cells was 0.862(95%CI:0.756-0.968).The AUC for the ratio of CD4^(+)/CD8^(+)cells was greater than that for levels of CD4^(+)and CD8^(+)cells(P<0.05).Conclusion Microbial infection and immune imbalance are independent risk factors for the development of HSP,and CD4^(+)/CD8^(+)has a good diagnostic value at detecting a pathogen causing HSP.
作者
胡西娟
王红心
王青玲
贺春兰
HU Xi-juan;WANG Qing-xin;WANG Qing-ling;HE Chun-lan(Department of Blood Transfusion,Affiliated Hospital of Qinghai University,Xining,Qinghai 810001,China;Department of Laboratory Medicine,Affiliated Hospital of Qinghai University)
出处
《中国病原生物学杂志》
CSCD
北大核心
2021年第11期1342-1345,共4页
Journal of Pathogen Biology
关键词
病原菌感染
过敏性紫癜
免疫细胞水平
诊断价值
pathogen infection
allergic purpura
the level of immune cells
diagnostic value
作者简介
胡西娟(1974-),女,陕西人,本科,主管检验师,主要从事输血相关研究。E-mail:duanhsui@163.com;通讯作者:贺春兰,E-mail:502435727@qq.com
