过敏性紫癜患儿血清可溶性CTLA-4表达变化与临床意义

Changes of Soluble Cytotoxic T-Lymphocyte-Associated Antigen-4 in Children with Henoch-Schonlein Purpura and Its Clinical Significance

摘要: 目的：探讨过敏性紫癜(Henoch-Schonlein Purpura, HSP)患儿急性期血清可溶性细胞毒性T细胞相关抗原-4 (sCTLA-4)的水平变化及意义。方法：选择2017年12月至2018年5月期间住院治疗的HSP患儿49例为研究对象(HSP组)，62名健康儿童为正常对照组(对照组)，应用双抗体夹心法酶联免疫吸附试验(ELISA)检测HSP患儿和对照组儿童血清sCTLA-4的浓度。结果：HSP组患儿急性期血清sCTLA-4水平为(3749.5 ± 804.5) pg/ml；明显低于对照组[(5101.8 ± 566.7) pg/ml]，差异有显著统计学意义(P < 0.01)。有/无前驱感染的HSP患儿血清sCTLA-4水平分别为(3446.1 ± 773.2) pg/ml和(4065.6 ± 723.0) pg/ml (P > 0.05)，有/无早期肾损害的HSP组患儿血清sCTLA-4水平分别为(3801.6 ± 839.7) pg/ml和(3724.3 ± 799.0) pg/ml，急性期有/无消化道症状的HSP患儿血清sCTLA-4水平分别为(3927.8 ± 242.3) pg/ml和(3670.9 ± 126.9) pg/ml (P > 0.05)，各组间差异均无统计学意义(P均 > 0.05)。HSP组患儿急性期血清sCTLA-4水平与免疫球蛋白IgA、IgG、IgM、IgE水平间均无明显相关性(r = −0.172~0.187，P均 > 0.05)。结论：HSP患儿急性期血清sCTLA-4水平降低，T细胞抑制信号不足，提示sCTLA-4在儿童HSP的发病机制中可能发挥一定作用。

Abstract: Objective: To investigate the changes and significance of serum soluble cytotoxic t-cell-associated antigen-4 (sCTLA-4) in patients with Henoch-Schonlein purpura (HSP) in acute phase. Methods: 49 children hospitalized with HSP from December 2017 to May 2018 were selected as study subjects (HSP group), and 62 healthy children were selected as normal control group (control group). Serum sCTLA-4 concentrations of children with HSP and control group were detected by double-antibody sandwich ELISA. Results: The serum sCTLA-4 level in HSP group was (3749.5 ± 804.5) pg/ml. It was significantly lower than the control group [(5101.8 ± 566.7) pg/ml], and the difference was statistically significant (P < 0.01). Serum sCTLA-4 levels in children with/without prodrome infection were (3446.1 ± 773.2) pg/ml and (4065.6 ± 723.0) pg/ml (P > 0.05), respectively. Serum sCTLA-4 levels in children with/without early renal damage in the HSP group were (3801.6 ± 839.7) pg/ml and (3724.3 ± 799.0) pg/ml, respectively. Serum sCTLA-4 levels of HSP children with/without gastrointestinal symptoms in the acute phase were (3927.8 ± 242.3) pg/ml and (3670.9 ± 126.9) pg/ml (P > 0.05), respectively, and there was no statistically significant difference between each group (all P > 0.05). There was no significant correlation between serum sCTLA-4 levels and immunoglobulin IgA, IgG, IgM, IgE levels in HSP group (r = −0.172 - 0.187, all P > 0.05). Conclusion: Serum sCTLA-4 level in children with HSP in acute phase is reduced, and T cell inhibition signal is insufficient, suggesting that sCTLA-4 may play a certain role in the pathogenesis of HSP in children.