目的 探讨皮肤血管炎(CV)患者血清D-二聚体、血小板活化因子乙酰水解酶(PAF-AH)水平在治疗过程中的变化,评价其辅助诊断和疗效评判价值.方法 选取2020年2月至2023年2月该院收治的84例CV患者作为观察组,其中变应性CV 31例,过敏性紫癜32例,结节性CV 21例,选取同期体检的50例健康人作为对照组,比较两组血清D-二聚体、PAF-AH水平.观察组治疗2周后评估疗效,并比较不同疗效患者D-二聚体、PAF-AH水平.采用受试者工作特征(ROC)曲线分析D-二聚体、PAF-AH诊断CV及评估疗效的效能.结果 与对照组比较,观察组D-二聚体水平更高,PAF-AH水平更低(P＜0.05).变应性CV、过敏性紫癜、结节性CV患者D-二聚体水平高于对照组,PAF-AH水平低于对照组(P＜0.05).D-二聚体、PAF-AH诊断CV的曲线下面积(AUC)值为0.754、0.712(P＜0.05),二者比较差异无统计学意义(P＞0.05).观察组治疗2周后痊愈11例(13.10％),显效23例(27.38％),有效27例(29.76％),无效23例(27.38％),临床有效率为72.62％.与治疗前比较,治疗后观察组D-二聚体水平降低,PAF-AH水平升高(P＜0.05).与无效患者比较,痊愈、显效、有效患者D-二聚体水平更低,PAF-AH水平更高(P＜0.05).D-二聚体、PAF-AH评估疗效的AUC值为0.785、0.718(P＜0.05).结论 CV患者存在血清D-二聚体升高,PAF-AH降低,二者可作为CV辅助诊断、疗效判断的参考依据.
Objective To investigate the changes of serum D-dimer and platelet activating factor acetyl-hydrolase(PAF-AH)levels during the treament process in the patients with cutaneous vasculitis(CV),and to judging the evaluation value of auxiliary diagnosis and therapeutic effect.Methods A total of 84 patients with CV admitted and treated in this hospital from February 2020 to February 2023 were selected as the ob-servation group,including 31 cases of allergic CV,32 cases of allergic purpura and 21 cases of nodular CV,and 50 healthy people undergoing physical examination during the same period were selected as the control group.Serum D-dimer and PAF-AH levels were compared between the two groups.The curative effect of the obser-vation group was evaluated after two weeks of treatment.The D-dimer and PAF-AH levels were compared a-mong the patients with different curative effects.The receiver operating characteristic(ROC)curve was a-dopted to analyze the efficeincy of D-dimer and PAF-AH for diagnosing CV and evaluating the treatment effect.Results The serum D-dimer of the observation group was higher than that of the control group,and the PAF-AH level was lower than that of the control group(P＜0.05).The level of D-dimer in the patients with allergic VC,anaphylactoid purpura and nodular VC was higher than that in the control group,while the level of PAF-AH was lower than that in the control group(P＜0.05).The area under the curve(AUC)val-ues of D-dimer and PF-AH for diagnosing CV were 0.754 and 0.712(P＜0.05),and there was no statistical difference between them(P＞0.05).After two weeks of treatment,11 cases(13.10％)were cured,23 cases(27.38％)had obvious effect,27 cases(29.76％)were effective,and 23 cases(27.38％)were ineffective.The clinical effective rate was 72.62％.Compared with before treatment,the level of D-dimer after treatment in the observation group was decreased and the level of PAF-AH was increased(P＜0.05).Compared with the inef-fective patients,the level of D-dimer in the patients with cure,significant effect and effect was lower,and the level of PAF-AH was higher(P＜0.05).The area under the curve(AUC)values of D-dimer and PAF-AH for evaluating the treatment effect were 0.785 and 0.718 respectively(P＜0.05).Conclusion Serum D-di-mer increased and PAF-AH decreased in CV patients.These two indexes could serve as the reference for the auxiliary diagnosis and curative effect judgment of CV.
罗文娟;王刚
青海大学附属医院皮肤科,西宁 810012
临床医学
皮肤血管炎;D-二聚体;血小板活化因子乙酰水解酶;疗效;ROC曲线
cutaneous vasculitis;D-dimer;platelet activating factor acetylhydrolase;curative effect;re-ceiver operating characteristic curve
《重庆医学》 2024 (007)
1004-1008,1015 / 6
青海大学附属医院中青年科研基金一般项目(ASRF-2019-YB-13).
10.3969/j.issn.1671-8348.2024.07.008
评论