| Objective: The long-term prognosis of IgA vasculitis depends on the degree of renal damage.Studies on the pathogenesis of IgA vasculitis with renal damage have found that cytokines play an important role in mediating and driving renal damage.This article investigates the changes in serum cytokine levels of IgA vasculitis and newly diagnosed children with renal damage,and explores the significance and value of cytokines in the process of IgA vasculits with renal damage.Methods:194 children were selected as the case group,of which 97 were children with IgA angculitis and 97 were diagnosed with initial renal impairment.The patients came from the pediatric nephrology department in Shengjing Hospital,Shenyang from January 2018 to June 2020.The control group was 60 healthy children undergoing physical examination in the child health care department of our hospital in the same period.The research data of the three groups of children first visited the hospital,including age,gender,cytokinine and other factors,and the SPSS 24.0software was used to conduct relevant statistical analysis operations.Results: In this cross-sectional study,serum cytokine concentration in 97 children with IgA vasculitis with renal damage were compared with 97 children with IgA vasculitis and 60 healthy children.IL-2 index were significantly higher in IgAV group than in the IgAV-N group and significantly higher in the IgAV-N group than in the healthy control group.In terms of IL-17 index,the IgAV-N group was significantly higher than IgAV group,And the IgAV group was significantly higher than the healthy control group;In IL-6、IL-10 and TNF-α,the IgAV group was significantly higher than IgAV-N group and healthy control group,and there was no significant difference between the IgAV-N group and healthy control group.IL-4 index in the IgAV-N group was significantly higher than those in the IgAV group and healthy control group,and there was no significant difference between the IgAV group and healthy control group.The IFN-γ index in the IgAV-N group and healthy control group were significantly higher than the IgAV group,and there was no significant difference between the IgAV-N group and the healthy control group.Logistic regression analysis showed that IL-2、IL-17、IFN-γ、TNF-α had independent and significant effects on the occurrence of IgAV-N(P< 0.05).Receiver operating characteristic(ROC)curve was used to evaluate the diagnosis ability of the influencing factors.The AUC value of IL-2 was 0.5889,sensitivity 38%,specificity47%.The AUC value of IL-17 was 0.6207,sensitivity 47.4% and the specificity was77.3%.The AUC value of IFN-γ was 0.6879,the sensitivity was 75% and the specificity was 55.7%.The AUC value of TNF-α was 0.6139,Sensitivity 42%,Specificity 37%.The AUC value of IL-17 and IFN-γ combined diagnosis was 0.710,the sensitivity 71.1%,Specificity 66%.According to Youden index,the cut-off values were respectively 1.125pg/ml、10.795pg/ml、1.085pg/ml、1.695pg/ml.Conclusion: 1.The levels of IL-17 and IFN-γ in serum cytokines in children with IgA vasculitis with renal damage are significantly higher,which are significantly different from those in the IgA vasculitis group.2.Using receiver operating characteristic curve analysis,the best cut-off values of IL-17 and IFN-γ are 10.795pg/ml and 1.085pg/ml,respectively.The higher the value of the index,the more likely it is to become involved in the kidney.IgA vasculitis with renal damage.3.The specificity of IL-17 index is 77.3%,which is higher than the sensitivity of47.4%;the sensitivity of IFN-γ index is 75%,which is higher than the specificity of55.7%.Analysis of the combined diagnosis ability of the two can improve the specificity To 66%,the sensitivity is 71.1%.Therefore,early detection of serum levels and dynamic monitoring of their changes play an early warning role in the early detection of kidney involvement and adjustment of treatment plans,but whether it can be used to treat renal damage remains to be further researched and analyzed. |
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