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| 血清CXCL13 CXCR4与儿童免疫性血小板减少症治疗反应的关系 |
| Relationship between serum CXCL13, CXCR4 and therapeutic response of children with immune thrombocytopenia |
| 投稿时间：2025-01-16 |
| DOI：10.3969/j.issn.1000-0399.2025.11.008 |
| 中文关键词: 儿童免疫性血小板减少症 CXC趋化因子配体13 CXC趋化因子受体4 病情 治疗反应 |
| 英文关键词: Childhood immune thrombocytopenia CXC motif chemokine ligand 13 CXC chemokine receptor type 4 Disease severity Treatment response |
| 基金项目:河北省卫健委课题项目(编号:20250541) |
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| 中文摘要: |
| 目的 探讨血清CXC趋化因子配体13(CXCL13)、CXC趋化因子受体4(CXCR4)在儿童免疫性血小板减少症（ITP）病情及治疗反应中的表达情况及临床意义。方法 选择2019年10月至2021年6月廊坊市中医院收治的160例初诊为ITP的患儿（ITP组），并选择同期在门诊体检的100例健康儿童为对照组。依据ITP病情严重程度分为重症组（n=26）和非重症组（n=134）；依据治疗反应分为完全反应组（n=79）、反应组（n=50）和无效组（n=31），并将完全反应组及反应组纳入治疗有效组（n=129），无效组纳入治疗无效组（n=31）。采用受试者工作特征（ROC）曲线分析血清CXCL13、CXCR4水平对ITP病情程度及治疗效果的预测价值。Pearson分析ITP组治疗前CXCL13、CXCR4与PLT的相关性。结果 不同病情严重程度的ITP患者CXCL13、CXCR4水平比较，差异具有统计学意义（P<0.05）,CXCL13水平重症组高于非重症组和对照组，非重症组高于对照组；CXCR4水平重症组低于非重症组和对照组，非重症组低于对照组（P<0.05）;CXCL13、CXCR4联合预测ITP患者病情严重程度的曲线下面积（AUC）为0.890，优于单独检测（0.853、0.775）；治疗前，ITP组CXCL13水平与PLT呈负相关，CXCR4水平与PLT呈正相关（r=-0.322,0.173,P均<0.05）；完全反应组和反应组患者治疗后的CXCL13水平均低于无效组，治疗后的CXCR4水平均高于无效组（P<0.05）；治疗后CXCL13、CXCR4联合预测ITP患者治疗效果的AUC为0.906，优于单独检测（0.798、0.790）(P均<0.05)。结论 血清CXCL13、CXCR4具有成为评估ITP患儿病情严重程度及治疗反应的生物标志物的潜力。 |
| 英文摘要: |
| Objective To investigate the expression and clinical significance of serum C-X-C motif chemokine ligand 13（CXCL13） and C-X-C chemokine receptor type 4（CXCR4） in the disease condition and treatment response of children with immune thrombocytopenia（ITP）. Methods A total of 160 children with ITP diagnosed for the first time in Langfang Hospital of Traditional Chinese Medicine from October 2019 to June 2021 were selected（ITP group）, and 100 healthy children who underwent physical examinations in the Outpatient Department during the same period were selected as the control group.According to the severity of ITP, they were divided into the severe group（n=26） and the non-severe group（n=134）.According to the treatment response, they were divided into the complete response group（n=79）, the response group（n=50）, and the non-response group（n=31）.The complete response group and the response group were included in the effective treatment group（n=129）, and the non-response group was included in the ineffective treatment group（n=31）.The receiver operating characteristic（ROC） curve was used to analyze the predictive value of serum CXCL13 and CXCR4 levels for the disease severity and treatment effect of ITP patients.Pearson correlation analysis was performed to analyze the correlation between CXCL13, CXCR4 and platelet（PLT） before treatment in the ITP group. Results The levels of CXCL13 and CXCR4 in ITP patients with different degrees of severity had statistically significant differences; the level of CXCL13 in the severe group was higher than that in the non-severe group and the control group, and the level in the non-severe group was higher than that in the control group. The level of CXCR4 in the severe group was lower than that in the non-severe group and the control group, and the level in the non-severe group was lower than that in the control group（P＜0.05）.The area under the curve（AUC） of the combined prediction of the disease severity of ITP patients by CXCL13 and CXCR4 was 0.890, which was better than that of individual detection（0.853, 0.775）.Before treatment in the ITP group, the level of CXCL13 was negatively correlated with PLT, and the level of CXCR4 was positively correlated with PLT（r=-0.322, 0.173, all P＜0.05）. After treatment, the levels of CXCL13 in the patients of the complete response group and the response group were lower than those in the non-response group, and the levels of CXCR4 were higher than those in the nonresponse group（P＜0.05）.The AUC of the combined prediction of the treatment effect of ITP patients by CXCL13 and CXCR4 after treatment was 0.906, which was better than that of individual detection（0.798, 0.790）（all P＜0.05）. Conclusion Serum CXCL13 and CXCR4 have the potential to become biomarkers for evaluating the disease severity and treatment response of children with ITP. |
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