慢性荨麻疹患儿血清25-OH-VD、FⅦa、FⅫa及D-D表达及意义
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摘要
目的研究血清25羟维生素D(25-OH-VD)、活化凝血因子Ⅶ(FⅦa)、活化凝血因子Ⅻ(FⅫa)及D-二聚体(D-D)在慢性荨麻疹患儿中的表达及其临床意义。方法选取2016年9月至2017年5月本院收治的慢性荨麻疹患儿78例(慢性荨麻疹组)、慢性荨麻疹恢复期患儿62例(慢性荨麻疹恢复期组)及同期健康体检儿童71例(健康对照组)作为研究对象。采用酶联免疫吸附法检测3组研究对象血清25-OH-VD、FⅦa、FⅫa,采用干式免疫散射色谱法检测血清D-D水平。结合病情对慢性荨麻疹患儿血清D-D水平进行分析,并研究各指标的相关性。结果慢性荨麻疹组患儿血清FⅦa及D-D水平均显著高于慢性荨麻疹恢复期组和健康对照组,25-OH-VD水平均显著低于慢性荨麻疹恢复期组和健康对照组,差异均有统计学意义(P<0.05);3组研究对象血清FⅫa水平相当,差异无统计学意义(P>0.05)。随着慢性荨麻疹患儿血清D-D水平升高,患儿慢性荨麻疹患病程度具有随之加重的趋势。慢性荨麻疹患儿血清D-D水平与25-OH-VD水平呈负相关(r=-0.335,P<0.05),与FⅦa呈正相关(r=0.225,P<0.05),与FⅫa无关(r=0.058,P>0.05)。结论慢性荨麻疹与血清25-OH-VD水平及凝血机制存在关联性,且外源性凝血机制在慢性荨麻疹的发生、发展中具有重要作用。血清D-D水平可对慢性荨麻疹病情程度的界定提供一定的参考价值。
Objective To study the expression and clinical significance of serum 25 hydroxy vitamin D(25-OH-VD),Activated coagulation factorⅫ(FⅫa)and activated coagulation factorⅦ(FⅦa)and D-dimer(DD)in children with chronic urticaria.Methods 78 cases of chronic urticaria,62 cases of children with chronic urticaria recovery and 71 cases of healthy children admitted to the hospital from September 2016 to May 2017 were selected as the subjects.The serum levels of 25-OH-VD,FⅦa and FⅫa were measured by enzyme-linked immunosorbent assay,and the level of serum D-D was detected by dry immune scattering chromatography in three groups.The serum D-D level of children with chronic urticaria was analyzed according to their condition,and the correlation of each index was studied.Results The serum levels of FⅦa and D-D in children with chronic urticaria were significantly higher than those in the recovery group and the healthy control group,while the levels of 25-OH-VD in the chronic urticaria group were lower than those in the recovery group and the healthy control group,and the differences were statistically significant(P<0.05).The levels of serum FⅫa in the three groups were similar,with no significant difference(P>0.05).With the increase in serum levels of D-D in children with chronic urticaria,the prevalence of chronic urticaria in children was also increasing.The level of serum D-D in children with chronic urticaria was negatively correlated with the level of 25-OHVD(r=-0.335,P<0.05),which was positively correlated with FⅦa(r=0.225,P<0.05)and had no correlation with FⅫa(r=0.058,P>0.05).Conclusion Chronic urticaria is related to serum 25-OH-VD levels and coagulation mechanism,and exogenous coagulation mechanism plays an important role in the development of chronic urticaria.The level of serum D-D can provide a reference value for defining the severity of chronic urticaria.
Objective To study the expression and clinical significance of serum 25 hydroxy vitamin D(25-OH-VD),Activated coagulation factorⅫ(FⅫa)and activated coagulation factorⅦ(FⅦa)and D-dimer(DD)in children with chronic urticaria.Methods 78 cases of chronic urticaria,62 cases of children with chronic urticaria recovery and 71 cases of healthy children admitted to the hospital from September 2016 to May 2017 were selected as the subjects.The serum levels of 25-OH-VD,FⅦa and FⅫa were measured by enzyme-linked immunosorbent assay,and the level of serum D-D was detected by dry immune scattering chromatography in three groups.The serum D-D level of children with chronic urticaria was analyzed according to their condition,and the correlation of each index was studied.Results The serum levels of FⅦa and D-D in children with chronic urticaria were significantly higher than those in the recovery group and the healthy control group,while the levels of 25-OH-VD in the chronic urticaria group were lower than those in the recovery group and the healthy control group,and the differences were statistically significant(P<0.05).The levels of serum FⅫa in the three groups were similar,with no significant difference(P>0.05).With the increase in serum levels of D-D in children with chronic urticaria,the prevalence of chronic urticaria in children was also increasing.The level of serum D-D in children with chronic urticaria was negatively correlated with the level of 25-OHVD(r=-0.335,P<0.05),which was positively correlated with FⅦa(r=0.225,P<0.05)and had no correlation with FⅫa(r=0.058,P>0.05).Conclusion Chronic urticaria is related to serum 25-OH-VD levels and coagulation mechanism,and exogenous coagulation mechanism plays an important role in the development of chronic urticaria.The level of serum D-D can provide a reference value for defining the severity of chronic urticaria.
引文
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[13]孟英,刘宁,薛冰蓉,等.应用凝血标志物诊断创伤骨科术后静脉血栓形成的病例对照研究[J].中华检验医学杂志,2016,39(10):751-755.
[14]鲍慧,彭艾.维生素D的免疫功能及肾脏疾病中的应用[J].中华现代内科学杂志,2010,7(1):11-14.
[15]李嘉晨,关欣亮,刘欧,等.内源性凝血物质在急性Stanford A型主动脉夹层围手术期的变化[J].心肺血管病杂志,2017,36(7):528-533.
[2]王亚婷,石春蕊,师蓓,等.慢性自发性荨麻疹患者血清白细胞介素-35和转化生长因子β1的水平检测[J].临床皮肤科杂志,2017,46(4):256-257.
[3]陈奇权,宋志强,郝飞.老年性慢性荨麻疹的临床特点及治疗选择[J].中华皮肤科杂志,2017,50(8):616-618.
[4]王思,杨丽君,刘春景,等.233例慢性荨麻疹患者过敏原分布及其临床意义分析[J].标记免疫分析与临床,2017,24(6):655-658.
[5]中华医学会皮肤性病学分会免疫学组.中国荨麻疹诊疗指南(2014版)[J].中国实用乡村医生杂志,2015,22(17):45-47.
[6] ZUBERBIER T,ABERER W,ASERO R,et al.The EAACI/GA(2)LEN/EDF/WAO guideline for the definition,classification,diagnosis,and management of urticaria:the 2013revision and update[J].Allergy,2014,69(7):868-887.
[7]王朵勤,唐慧,沈燕芸,等.慢性荨麻疹患者血浆D二聚体、活化凝血因子Ⅶ及活化凝血因子Ⅻ水平的研究[J].中华皮肤科杂志,2015,48(1):37-40.
[8]王朵勤,徐金华.慢性荨麻疹发病机制研究进展[J].中国医师杂志,2017,19(1):25-28.
[9]刘佳,农祥.凝血机制参与慢性荨麻疹发病的研究进展[J].国际皮肤性病学杂志,2016,42(1):33-36.
[10]刘金星.养血祛风法治疗荨麻疹的临证体会[J].中国中医急症,2015,24(6):1021.
[11]尹嘉文,杨文林.慢性自发性荨麻疹患者血清维生素D与基质金属蛋白酶9的检测[J].中华皮肤科杂志,2016,49(11):815-817.
[12]张倩雯,梁碧华,李润祥,等.慢性自发性荨麻疹发病机制及其治疗的研究进展[J].皮肤性病诊疗学杂志,2015,22(4):332-335.
[13]孟英,刘宁,薛冰蓉,等.应用凝血标志物诊断创伤骨科术后静脉血栓形成的病例对照研究[J].中华检验医学杂志,2016,39(10):751-755.
[14]鲍慧,彭艾.维生素D的免疫功能及肾脏疾病中的应用[J].中华现代内科学杂志,2010,7(1):11-14.
[15]李嘉晨,关欣亮,刘欧,等.内源性凝血物质在急性Stanford A型主动脉夹层围手术期的变化[J].心肺血管病杂志,2017,36(7):528-533.