Analysis Of Clinical Characteristics And Humoral Immune Function Of Children With Different Types Of Henoch-Schonlein Purpura

Objectives:On the one hand,this present paper aims to provide valuable clues for the early discovery,early diagnosis,early treatment and prognosis of HSP by summarizing the epidemiological characteristics of children with hench-schonlein purpura(HSP)and analyzing the high risk factors of renal involvement of children with HSP;on the other hand,it is hoped to expound its pathogenic mechanism and provide a valuable basis by exploring the change rules of humoral immune function of children with HSP.Methods:Hospitalized information of 313 children with HSP(in initial onset group)and 32 children with HSP(in recurrence group)meeting the research requirements were collected from the People’s Hospital of Xiangxi Autonomous Prefecture from Jan.1,2018 to Dec.31,2019,including children age,predisposing factors,season,place of residence,main clinical symptoms,recurrence situation,hospital stays,serum IgG,IgM,IgA,anti-human C3 and anti-human C4 contents and relative information.In accordance with main clinical manifestations of children in the initial onset group,there were five clinical groups,namely skin type,joint type,abdominal type,kidney type and mixed type;in accordance with the frequency of onset,there were two groups,namely the initial onset group and recurrence group.In the control group,there were 61 healthy children.In this present paper,11 factors that may be related to the renal involvement were collected,including children age,gender,respiratory tract infection situation,joint involvement,abdominal organs involvement,joints and abdominal involvement,serum IgG,IgM,IgA,anti-human C3 and anti-human C4.The binary logistic regression equation was used to conduct the statistical analysis of the high risk factors of renal involvement of children with HSP.The immune scatter turbidity was used to detect the serum IgG,IgM,IgA,anti-human C3 and anti-human C4 of children in various groups,and the one-way analysis of variance as well as the statistical method of LSD-t test were used to compare between different clinical groups and initial onset group as well as between recurrence group and control group,respectively.The significance level was 0.05.When P<0.05,it was considered that the difference had the statistical significance.Results:In the initial onset group of children with HSP,there were 168 boys and 145 girls,with the male-female ratio of 1.16:1 and the average age of 7.84±2.75,including 72 skin type cases,85 joint type cases,57 abdominal type cases,33 kidney type cases and 66 mixed type cases,254 respiratory tract infection cases and 59 cases with unknown factors.The pathogenes mainly include mycoplasma pneumoniae,streptococcus and EB virus.There were 72 cases in Spring,28 cases in Summer,101 in Autumn,112 in Winter,of which there were 233 cases in rural areas and 80 cases in cities.Based on the evaluation of renal involvement factors of children with HSP,it was found that in terms of the onset age and joint involvement of children,all P values<0.05.And the joint involvement OR:0.455,95%CI:0.237～0.876,age OR(95%CI):1.125(1.015～1.247),and the remaining P values>0.05.Among children with HSP in different clinical groups,the difference of onset age and serum IgG had the statistical significance,and all P values<0.05;the difference of serum IgA,IgM,anti-human C3 and anti-human C4 had no statistical significance,and all P values>0.05;the average age of children with abdominal type and kidney type was older than those with skin type,and the average age of children with abdominal type,kidney type and mixed type was older than those with joint type.The IgG average content of children with skin type and joint type was greater than those with abdominal type and mixed type,all P values<0.05;the remaining difference had no statistical significance,and all P values>0.05.The pairwise comparison between the initial onset group,recurrence group and control group showed that the difference of serum IgA,IgG and anti-human C3 had statistical significance,and all P values<0.05;the difference of serum IgM and anti-human C4 had no statistical significance,and all P values>0.05;the serum IgG level of the initial onset group was higher than that of the recurrence group and control group,and all P values<0.05;the difference between the recurrence group and control group had no statistical significance,P>0.05;the IgA level of the initial onset group and recurrence group was higher than that of the control group,and all P values<0.05;the difference between the initial onset group and recurrence group had no statistical significance,P>0.05;the serum anti-human C3 of the initial onset group and recurrence group was higher than that of the control group,and all P values<0.05;the difference between the initial onset group and recurrence group had no statistical significance,P>0.05.Conclusions:(1)The onset age was related to the HSP clinical types,that was,the age of children with abdominal type,kidney type and mixed type was older than those with skin type and joint type.The onset age was the risk factors of renal involvement of children with HSP,and the joint involvement was the protective factor of renal involvement of children with HSP.(2)The serum IgG level was related to the HSP clinical types.There were humoral immune disorders in HSP children,that is,serum IgA,IgG and complement C3 levels in HSP children in the acute onset group were significantly higher than those in the healthy control group,and serum IgG levels in the onset group were significantly higher than those in the recurrent group.