关键词: 过敏性紫癜, 微小RNA-374b, 肾炎, 评估价值

Abstract: BackgroundKidney injury is common in Henoch Schonlein purpura(HSP) children, and it will result in HSP nephritis. The longterm prognosis of HSP is closely related to the degree of renal involvement in children. Therefore, it is of great significance to evaluate the possibility of nephritis and give targeted intervention as soon as possible. ObjectiveTo investigate the expression level of serum miR374b in children with HSP and its relationship with nephritis. DesignCasecontrol study. MethodsThe case group included the firstepisode children with HSP and was divided into the subgroup with nephritis and the subgroup without nephritis. The control group included healthy children in physical examination. The age in both groups were ≤14 years old. Peripheral venous blood(5 mL) was collected in both groups. The level of serum miR374b was detected by realtime fluorescence quantitative PCR. The clinical data of children in the case group were intercepted from the medical records, and the demographic data of children in the control group were obtained from the physical examination records. The influencing factors of nephritis in HSP children were analyzed. The diagnostic value of serum miR374b level in HSP children complicated with nephritis was analyzed by ROC curve. Main outcome measuresSerum miR374b level. ResultsThere were 103 cases in the case group, including 58 males, with an average age of (7.2±1.2) years and an average course of disease of (19.0±3.4) d, and there were 68 cases of simple skin purpura, 23 cases with abdominal pain, 17 cases with joint pain and 15 cases with gastrointestinal bleeding. There were 43 cases in the subgroup with nephritis and 60 cases in the subgroup without nephritis. There were 86 cases in the control group, including 46 males, with an average age of (7.0±1.1) years. The level of miR374b in the case group (0.69±0.13) was lower than that in the control group (1.36±0.24), P<0.01. The level of miR374b in the subgroup with nephritis (0.51±0.09) was lower than that in the subgroup without nephritis(0.82±0.15), P<0.01. Multivariate logistic regression analysis showed that age ≥ 7 years old (OR=2.82, 95%CI: 1.943.93), long course of disease (OR=3.50, 95%CI: 2.484.62), abdominal pain (OR=2.62, 95%CI: 1.873.57), joint pain (OR=2.59, 95%CI: 1.753.52), gastrointestinal bleeding (OR=2.68, 95%CI: 1.903.61), PLT high level (OR=3.66, 95%CI: 2.544.77) , WBC high level (OR=3.24, 95%CI: 2.114.42), FIB high level (OR=3.58, 95%CI: 2.514.71), abnormal urinary microglobulin (OR=3.36, 95%CI: 2.284.46), elevated blood IgA (OR=3.50, 95%CI: 2.394.58), elevated blood IgG (OR=3.53, 95%CI: 2.514.71) and elevated blood IgM (OR=3.96, 95%CI: 2.875.12) were the risk factors for nephritis in HSP children, while the ALB high level (OR=0.60, 95%CI: 0.370.83), HDL high level (OR=0.55, 95%CI: 0.310.72) and miR374b high level (OR=0.47, 95%CI: 0.140.65) were the protective factors for it. ROC curve showed that the cutoff value of serum miR374b level in predicting nephritis in HSP children was ≤ 0.65, and the sensitivity was 90.7%, and the specificity was 83.3%, and the AUC was 0.919 (95%CI: 0.8490.964). ConclusionThe expression level of serum miR374b in HSP children is decreased, and the decrease is more obvious in children with nephritis, which has a certain diagnostic value for children with HSP complicated with nephritis.

Key words: Henoch Schonlein purpura, MicroRNA-374b, Nephritis, Evaluation value