| Objectives:The study investigated the relationship between endothelium microparticles(EMP)and Henoch-schonlein purpura(HSP)with different clinical phenotypes,aimed to exploring whether EMP can be used as an index to predict HSP for multiple organ damage.Method:The 108 children with acute HSP who were admitted to the Department of Pediatrics,Affiliated Hospital of Hebei University from September 2017 to January 2019 were randomly divided into the simple group(20 cases)and the non-simple group(88).The non-simple type(HSP with organ damage)group included 23 cases of joint type,19 cases of nephritis type,20 cases of abdominal type,and 26 cases of mixed type.30 children in the health check-up at the same time in our hospital were selected as the control group.All subjects were between 1 and 14 years of age.Flow cytometry was used to detect EMP levels.At the same time,the correlation analysis was performed with the neutrophil/lymphocyte ratio(NLR ratio),cystatin C(Cysc),?2 microglobulin and CRP in the observation group.The ROC curve was used to evaluate the value of EMP in predicting organ damages in HSP.Result:1.The EMP level of observation group was 3.10(1.70,4.20)%,higher than that of healthy control group 0.15(0.08,0.30)%,the difference was statistically significant(P<0.05).2.The EMP level of non-simple group was higher than that of simple type group,and the difference was statistically significant(P<0.05).The EMP concentrations in the simple,joint,kidney,abdominal,and mixed type in the observation group were:(1.38±0.88)%,(2.56±1.43)%,(4.20±1.34)%,(2.95±1.71).%),(3.96±1.48)%,F=13.93,P=0 between groups.Comparison between two groups: There were significant differences between simple type and joint type group,simple type and kidney type group,simple type and abdominal type group,simple type and mixed type group,joint type and kidney type group,joint type and mixed type group,kidney type and belly type group,abdominal type and mixed type group(P<0.05).There were no significant differences between joint type and abdominal type group,kidney type and mixed type group(P>0.05).3.EMP was positively correlated with CRP(r=0.23,P=0.02),and the correlation was statistically significant.EMP was negatively correlated with Cysc(r=-0.15,P=0.11),and the correlation was not statistically significant.EMP was negatively correlated with?2-microglobulin(r=-0.21,P=0.06),and the correlation was not statistically significant.EMP was positively correlated with NLR(r=0.27,P=0),and the correlation was statistically significant.4.The ROC curve of each index predicting HSP complicated with multiple organ damage:the area under the ROC curve of EMP is 0.86,95% CI is(0.73,0.94),when the Yoden index is 0.63,the sensitivity(72.70%)and specificity(90.00%)of the ROC curve are better when the Yoden index is 2.10%(P<0.05).The area under the ROC curve of NLR is 0.64,95% CI is(0.51,0.75),and the sensitivity(55.70%)and specificity(55.00%)are better when the Yoden index is 0.11.The optimal limit value is 1.71 mg/ L(P>0.05).The area under the ROC curve of CRP is 0.62,95% CI is(0.50,0.74),and the sensitivity(56.80%)and specificity(60.00%)are better when the Joden index is 0.17 The optimal limit value is 4.55mg/ L(P>0.05).Conclusion:1.The level of EMP in the observation group was higher than that in the control group,suggesting that EMP is involved in the pathogenesis of HSP.2.The level of non-simple EMP is higher than that of simple type,suggesting that EMP can be used as a predictor of HSP combined organ damage,and the predicted value is larger than NLR and CRP.3.EMP was positively correlated with NLR and CRP,indicating that vascular injury and inflammatory reaction were accompanied by HSP. |
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