Expression Of IgG,IgG/C3,and NLR In The Progression Of Crescent Formation In Children With HSPN

Background and purpose:Henoch-schonlein purpura nephritis(HSPN),a more serious complication of allergic purpura,Henoch-Sch o nlein purpura(HSP),is also one of the common secondary glomerular diseases in childhood.Among them,the formation and proportion of the crescent moon in the glomerulus indicate the extent of kidney injury,and also has a direct impact on the prognosis of HSPN patients.The crescent moon is a pathological concept and is one of the morphological lesions of glomeruli in kidney injury.Whether the crescent moon is formed can only rely on glomerular biopsy by kidney puncture.Kidney puncture is traumatic,children have rejection psychology,and renal puncture has high technical requirements for the sampling personnel.At present for the crescent analysis focused on the pathology,from the laboratory humoral detection to reflect the progress of the crescent formation research itself,and more concentrated in IgA nephropathy,on the body fluid related indicators in HSPN nephropathy with crescent formation development has not been reported in detail,this study through testing some immunity,inflammation related indicators,analysis whether there is correlation in HSPN with crescent formation and progress,preliminary evaluation of crescent formation and progress,rich clinical understanding of the crescent.Methods:1.The selected subjects were mainly pediatric children diagnosed with HSPN in clinical and renal pathology in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2018 to January 2021,including a total of 229 patients,143 men and 86 women,with an average age of 10.59±3.09 years old,and all blood and urine were collected before renal puncture.In addition,10 physical examination children were recruited,and physical examination children were only tested for physical fluid indicators.According to the pathological results after renal puncture,the children were divided into crescent formation group(n=170),including 108 men and 62 women,with a mean age of 10.29 ± 2.82 years;without crescent formation group(n=59),including 35 men,24 women and a mean age of 10.70±3.18 years.According to the proportion of crescent formation,it is divided into four groups,0%of C0(n=58),1-10%of C1(n=85),11-25%of C2 group(n=59),>25%and<50%of C3(n=27),over 50%is another disease,so this part is excluded.2.UIgG,IgG,IgM,I g M,IgE,IgA,C3,C4 were detected in the presence or absence of crescent moon formation and progression.CD4 was detected by flow+T lymphocytes and CD8+When T lymphocytes have changes in crescent moon formation and progression,the changes of LYMPH and NEUT in crescent moon formation and progression were detected by the principle of electrical impedance.The ratio of IgG to C3,IgG/C3,NEUT to LYMPH cells,NLR,and UIgG to Ucr,GCR,were also calculated,and the expression changes of these three ratios between groups were also analyzed.3.For statistical analysis,all data used spss 21.0 for statistical analysis.According to whether the measurement data met normal distribution,mean ± standard deviation or quartile were used to indicate the range.Measurement data were analyzed by t-test,rank sum test,and had statistical significance at P<0.05.Correlation analysis between count data was performed by Spearman rank correlation analysis with correlation coefficients indicated by r and the distinguishing value of indicators analyzed by ROC curve.Results:1.The expression levels of IgE,IgM,IgA,C3,and C4 were not significantly significant between the two groups in HSPN patients,but IgG and IgG/C3 were significantly higher in the no crescent formation group than in the crescent formation group(P<0.01).2.The expression levels of UIgG and Ucr were non.significant(P>0.05),but their ratio,GCR,was higher in the group than without them(P<0.01).3.NEUT,and LYMPH were higher in the crescent formation group,significantly different(P<0.01),and the ratio of NLR was lower in the crescent formation group,respectively(P<0.01).4.CD4+T cells,CD4/CD8 were higher in the group without crescent formation and were statistically significant(P<0.05),CD8+There was no significant difference in T cell numbers between the two groups.5.After grouping according to the percentage size of the crescent formation,the results showed that the GCR(r=0.246),NLR(r=0.357),and NEUT(r=0.276)showed a positive correlation with the size of the crescent formation,with P<0.01.6.The results of the correlation analysis with the size of the crescent formation also showed that LYMPH(r=-0.222),IgG/C3(r=-0.449),and IgG(r=-0.457)showed a negative correlation between the four groups,with P<0.01.7.Due to the relatively high difference of I g g/C3,NLR and IgG between groups,they were divided into two groups according on whether there is crescent formation,drawn the ROC curve and analyzed as a value indicator of diagnostic crescent formation,so that the AUC of the three was 0.728,0.716 and 0.755,respectively,which showed the value of diagnostic crescent formation.Conclusion:In children with HSPN,the expression levels of IgG,IgG/C3,and NLR change significantly during the crescent moon formation.When the proportion of crescent moon formation gradually expands,the expression levels of IgG/C3 and IgG will gradually decrease,and the NLR will gradually increase.According to the correlation analysis with crescent formation,the dynamic monitoring of NLR,IgG/C3,and IgG can assist in the evaluation of crescent moon progression in children with HSPN.