Clinical Significance Of PTX3 In Children With Henoch-sch?nlein Purpura

Background Henoch-Sch?nlein purpura(HSP)is systemic vasculitis with small vasculitis as the main lesion.Its clinical features are that platelets do not reduce purpura,often involving the skin,gastrointestinal tract,kidney,joints,etc.The HSP involving kidney kidney damage called Henoch-Sch?nlein purpura nephritis(HSPN).The pathogenesis of HSP is not clear,and the long-term prognosis is mainly determined by the degree of renal involvement.Most of the renal symptoms occur in 6 months after skin purpura.Although the most prognosis is good,the children with recurrent hematuria and proteinuria have poor long-term prognosis.About 15% had sustained kidney damage,and about 8% progressed to renal failure.The probability of renal involvement is related to the appearance of early renal symptoms.Pentraxin 3(PTX3),a new inflammatory biological marker,is closely related to many immune system related diseases.High expression of PTX3 can be found in all immune related diseases.The purpose of the study was to detect the expression of PTX3 in plasma and urine of children with HSP and to explore its clinical significance in chidren with HSP.Objective To detect the expression of PTX3 in plasma and urine of children with HSP and HSPN,and to explore its clinical significance.Methods 50 children with HSP were enrolled from March,2016 to September,2017 and divided into two groups: HSP group(n=32),HSPN group(n=18).20 healthy children(control group)with physical examination in outpatient department were enrolled on the corresponding period.The expression level of PTX3 in plasma and urine were detected.Results 1.There were no significant difference in the age and sex ratio between the children in each group(control,HSP and HSPN groups)(P>0.05).2.The expressions of plasma PTX3 in control group were(4.02±1.50)ng/ml,the expressions of plasma PTX3 in HSP group were(6.99±2.02)ng/ml and the expressions of plasma PTX3 in HSPN group were(10.09±1.04)ng/ml.The expressions of plasma PTX3 in HSP group were significantly higher than that of control group(t=5.663,P=0.000),and the difference was statistically significant(P<0.05);the expressions of plasma PTX3 in HSPN group were significantly higher than that of control group(t=14.337,P=0.000),and the difference was statistically significant(P<0.05);the expressions of plasma PTX3 in HSPN group were significantly higher than that of HSP group(t=6.056,P=0.000),and the difference was statistically significant(P<0.05).3.The expressions of urine PTX3 in control group were(4.18±1.34)ng/ml,the expressions of urine PTX3 in HSP group were(6.11±2.37)ng/ml and the expressions of urine PTX3 in HSPN group were(11.80±1.32)ng/ml.The expressions of urine PTX3 in HSP group were significantly higher than that of control group(t=3.318,P=0.002),and the difference was statistically significant(P<0.05);the expressions of urine PTX3 in HSPN group were significantly higher than that of control group(t=17.627,P=0.000),and the difference was statistically significant(P<0.05);the expressions of urine PTX3 in HSPN group were significantly higher than that of HSP group(t=9.374,P=0.000),and the difference was statistically significant(P<0.05).4.The expressions of plasma PTX3 in HSP group during the recovery period were(5.22 ± 2.06)ng / ml,the expressions of plasma PTX3 in HSPN group during the recovery period were(7.14 ± 1.13)ng / ml.The expressions of plasma PTX3 in HSP group were significantly lower than that during the acute period(t=3.708,P=0.001),and the difference was statistically significant(P<0.05);the expressions of plasma PTX3 in HSPN group were significantly lower than that during the acute period(t=12.546,P=0.000),and the difference was statistically significant(P<0.05).5.The expressions of urine PTX3 in HSP group during the recovery period were(4.46±2.34)ng / ml,the expressions of urine PTX3 in HSPN group during the recovery period were(7.35±1.23)ng / ml.The expressions of urine PTX3 in HSP group were significantly lower than that during the acute period(t=3.327,P=0.003),and the difference was statistically significant(P<0.05);the expressions of urine PTX3 in HSPN group were significantly lower than that during the acute period(t=9.364,P=0.000),and the difference was statistically significant(P<0.05).Conclusion The detection of the expressions of PTX3 not only reflect the active state of HSP disease,but also may be a new detection index of renal damage in children with HSP.