Objective To analyzed the relationship between serum heat shock protein 60(HSP60),heat shock pro-tein 70(HSP70)and helper T cell 17/regulatory T cell(Th17/Treg)cells and prognosis in children with primary immune thrombocytopenia(ITP).Methods One hundred and twenty-eight ITP children diagnosed and treated in the Department of Pediatrics,Baoshan People's Hospital from June 2020 to June 2022 were selected as observation group,and 60 healthy chil-dren in the same period were selected as control group.The levels of serum HSP60,HSP70 and Th17/Treg cells were detec-ted and compared between two groups.The correlation between serum HSP60,HSP70 and Th17/Treg cells was analyzed by Pearson method.ITP children were followed up for 1 year after discharge,and were divided into good prognosis subgroup and poor prognosis subgroup according to different prognosis.The clinical data of ITP children were collected,the influen-cing factors of prognosis in ITP children were analyzed by univariate and multivariate Logistic regression models,and the risk prediction nomogram model was constructed.The predictive value of serum HSP60,HSP70 and Th17/Treg cells on the prognosis of ITP children was analyzed by established receiver operating characteristic(ROC)curve.Results The levels of serum HSP60,HSP70 and Th17/Treg cells in observation group were significantly higher than those in control group(t/Z/P=20.445/＜0.001,17.467/＜0.001,5.823/＜0.001).Pearson analysis showed that,serum HSP60 and HSP70 were positively correlated with Th17/Treg cells(r/P=0.417/＜0.001,0.348/＜0.001).Multivariate Logistic regression analysis showed that,high HSP60,high HSP70,and high Th 17/Treg levels were independent risk factors[OR(95％CI)=1.177(1.041-1.331),1.181(1.038-1.343),9.895(2.171-68.177)]for poor prognosis in ITP children,and high PLT count at initial diagnosis was a protective factor[OR(95％CI)=0.848(0.726-0.990)].The results of ROC curve analysis showed that,the AUC of PLT count,HSP60,HSP70,Th17/Treg level and nomogram model at the initial diagnosis were 0.793,0.730,0.787,0.840 and 0.975 respectively.The Bootstrap method(B=1 000)was used to verify the nomogram model internally,the Bias-corrected predic-tion curve was basically coincident with the Ideal line,and the prediction ability of the model was better.The decision curve shows that,the threshold probability range of the model was 0.01-0.98,and its net return rate was＞0,which was higher than the two invalid lines.Conclusion The levels of serum HSP60,HSP70 and Th17/Treg in IPT children are significantly increase,and serum HSP60 and HSP70 are positively correlated with Th17/Treg.PLT count,HSP60,HSP70 and Th17/Treg levels at initial diagnosis are the influencing factors of poor prognosis in ITP children,and the nomogram model based on independent risk factors such as HSP60 and HSP70 has a good predictive value for poor prognosis in ITP children.
Primary immune thrombocytopeniaHeat shock protein 60Heat shock protein 70Th17/Treg cellsPrognosisNomogram
维普
万方数据
