摘要
Abstract
Objective To investigate the association between trajectories of Th17/Treg cell ratio chan-ges and the risk of recurrence in children with Henoch-Schönlein purpura(HSP).Methods Clinical data from 128 children with HSP admitted to our hospital between January 2022 and October 2023 were collected and followed up.A latent class growth model(LCGM)was applied to identify distinct trajectories of changes in the Th17/Treg cell ratio.Cox regression was used to evaluate the association between Th17/Treg trajectory patterns and the risk of HSP recurrence.Results Three distinct Th17/Treg trajectory patterns were identified and cate-gorized as a low-level increasing group(n=30),a medium-level decreasing group(n=31),and a high-level stable group(n=67).The serum levels of SOD,CD3+,CD4+,CD4+/CD8+ratio,and Treg cells were significantly higher in the high-level stable group than in the other two groups,whereas levels of AOPP,MDA,CD8+,Th17 cells,and the Th17/Treg ratio were significantly lower(all P＜0.05).Significant differences among the three trajectory groups were observed in terms of age,rash recurrence,length of hospi-talization,infection status,joint pain at initial onset,abdominal pain at initial onset,post-discharge exercise restriction,dietary control,and oral glucocorticoid use(all P＜0.05).Polynomial logistic regression analy-sis showed that,compared with the low-level increasing group,children age 7-12 years who experienced fewer recurrent rashes,had no bacterial infection,had no exercise restrictions after discharge,and had a longer re-covery period were more likely to belong to the medium-level decreasing group or the high-level stable group.Compared with the medium-level decreasing group,these same factors were associated with a higher likelihood of belonging to the high-level stable group.Cox regression analysis demonstrated that the trend tests for hazard ratios(HR,95％CI)in the medium-level decreasing group and the high-level stable group were statistically significant when compared with the low-level increasing group(P＜0.05).Subgroup analyses in-dicated that the risk of recurrence was significantly lower in the high-level stable group than in the medium-level decreasing group across subgroups stratified by age,rash recurrence,infection status,and post-discharge ex-ercise restriction(P＜0.05).No significant interactions were observed between Th17/Treg trajectory patterns and these subgroup variables(all P interaction＞0.05).Conclusion Trajectories of Th17/Treg cell ratio chan-ges was significantly associated with the risk of recurrence in children with HSP.Monitoring dynamic changes in Th17/Treg balance and implementing targeted preventive strategies may help reduce disease recurrence in pedi-atric Henoch-Schönlein purpura.关键词
过敏性紫癜/儿童/Th17/Treg/复发/影响因素Key words
Henoch-Schonlein purpura/children/Th17/Treg/recurrence/influencing factors
