| 血清胆红素水平变化在IgA血管炎儿童发生肾损伤中的预测价值 |
| 投稿时间：2024-11-06 修订日期：2024-12-10 点此下载全文 |
| 引用本文：朱宛莹,王凌超,韦娜,马唯唯,郭潇楠,赵德安.血清胆红素水平变化在IgA血管炎儿童发生肾损伤中的预测价值[J].医学研究杂志,2025,54(5):88-92 |
| DOI：
10.11969/j.issn.1673-548X.2025.05.017 |
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| 基金项目:河南省医学科技攻关计划项目(LHGJ2022061)；新乡医学院第一附属医院青年培育基金项目(QN-2020-B20) |
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| 中文摘要:目的 评估血清胆红素在儿童IgA血管炎(immunoglobulin A vasculitis,IgAV)肾炎(IgA vasculitis nephritis,IgAVN)中的水平变化及在IgAVN诊断中的作用。方法回顾性分析了2021年10月~2023年7月期间新乡医学院第一附属医院收治的134例IgAV患者的临床资料,以有无肾脏受累分为IgAV组(n= 89)和IgAVN组(n= 45),同期选择住院检查的40例特发性身材矮小症患儿为对照组。采用方差分析统计各组临床参数和血清总胆红素水平差异,Spearman 相关分析和多因素Logistic回归分析各参数的相关性,ROC曲线评价诊断的敏感度、特异性。结果 IgAV组、IgAVN组血总胆红素(total bilirubin,TBIL)、间接胆红素(indirect bilirubin,IBIL)水平明显低于对照组(P＜0.05),IgAVN组TBIL、IBIL、直接胆红素(direct bilirubin,DBIL)水平明显低于 IgAV组(P＜0.05)；IgAVN组TBIL、IBIL水平与IgAVN发生风险呈负相关。TBIL、IBIL对于诊断IgAVN的特异性分别为86.5％、68.5％,敏感度分别为46.7％、51.1％。血清胆红素结合多变量的预测模型AUC达到0.817(95% CI:0.744~0.891,P<0.001),敏感度为79.8%,特异性为66.7%。结论 临床测定胆红素水平对鉴别评估IgAV患儿是否发生肾累及(IgAVN)具有一定的临床价值。 |
| 中文关键词:胆红素 IgA血管炎 肾炎 儿童 |
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| Predictive Value of Serum Bilirubin Levels on Renal Injury in Children with IgA Vasculitis |
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| Abstract:Objective To evaluate the changes in serum bilirubin levels in children with IgA vasculitis (IgAV) nephritis (IgAVN) and its role in the diagnosis of IgAVN. Methods The clinical data of 134 patients with IgAV who were admitted to the First Affiliated Hospital of Xinxiang Medical College from October 2021 to July 2023 were retrospectively analyzed. They were divided into IgAV group (89 cases) and IgAVN group (45 cases) according to the presence or absence of renal involvement. During the same period, 40 children with idiopathic short stature who were hospitalized for examination were selected as the control group. Variance analysis was used to statistically analyze the differences in clinical parameters and serum total bilirubin levels among the groups. Spearman correlation analysis and multivariate Logistic regression analysis were used to evaluate the correlation of the parameters. ROC curve was used to evaluate the sensitivity and specificity of diagnosis. Results The levels of TBIL and IBIL in the IgAV and IgAVN groups were significantly lower than those in the control group (P<0.05), and the levels of TBIL, IBIL and DBIL in the IgAVN group were significantly lower than those in the IgAV group (P<0.05). TBIL and IBIL levels were negatively correlated with IgAVN. The specificity of TBIL and IBIL for diagnosing IgAVN was 86.5% and 68.5%, with sensitivities of 46.7% and 51.1%, respectively. When combined with other variables, the serum bilirubin prediction model achieved an AUC of 0.817 (95% CI:0.744-0.891, P<0.001), with a sensitivity of 79.8% and specificity of 66.7%. Conclusion The determination of serum bilirubin level has a certain clinical value in predicting the occurrence of renal involvement (IgAVN) in children with IgAV. |
| keywords:Serum bilirubin IgA vasculitis Nephritis Children |
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