过敏性紫癜肾炎及IgA肾炎患儿尿液IL-1β和MCP-1检测的意义

Clinical Significance on Urinary Interleukin-1β and Monocyte Chemoattractant Protein-1 in Children with Henoch-Schonlein Purpura Nephritis and IgA Glomerular Nephritis

目的检测过敏性紫癜肾炎(HSPN)及IgA肾炎(IgAGN)患儿尿液白细胞介素-1β(IL-1β)及其受体拮抗剂(IL-1ra),单核细胞趋化蛋白-1(MCP-1)水平,探讨它们在两种疾病中的临床意义。方法测定25例HSPN、23例IgAGN、30例正常儿童尿液IL-1β、IL-1ra、MCP-1水平。尿液IL-1ra、MCP-1水平用ELISA测定,IL-1β用放射免疫法测定。结果三组尿液IL-1ra排泄水平无显著差异(P>0.05);HSPN、IgAGN组尿液IL-1β水平显著升高,均高于正常对照组(P<0.01);HSPN、IgAGN组尿液IL-1ra/IL-1β显著低于正常对照组(P<0.05)。HSPN及IgAGN组尿液MCP-1均显著高于正常对照组(P<0.01或P<0.05),而HSPN组与IgAGN组之间亦有显著差异(P<0.01)。尿液IL-1ra、IL-1β、IL-1ra/IL-1β与24小时尿蛋白无显著相关性(r=0.038,r=0.023,r=0.15,P>0.05);尿液MCP-1与24小时尿蛋白呈正相关(r=0.48,P<0.05)。结论HSPN与IgAGN患儿尿液IL-1ra、IL-1β、MCP-1排泄量不完全相同,检测尿液中IL-1ra、IL-1β、IL-1ra/IL-1β、MCP-1可能无创性反映HSPN和IgAGN肾组织中免疫炎症细胞浸润水平,对评估肾病变及病情活动进展有一定的临床意义。

Objective To investigate the clinical significance of urinary intedeukin-1β（IL-1β）,interleukin-1 receptor antagonist（ IL-lra）, rnonoeyte chernoattractant protein-1 （MCP-1） in children with Henoeh-Sehonlein purprua nephritis（HSPN） and IgA glomerular nephritis （IgAGN）. Methods The levels of IL-1β,IL-lra and MCP-1 in urine samples collected from 25 patients with HSPN, 23 patients with IgAGN and 30 healthy subjects were determined. The urinary leves of IL-lra, MCP-1 were determined by an enzyme-linked immunosorbent assay （ELISA） ,and the urinary level of IL-1β by means of radioimmunoassay. Results There was insignificant difference in the urinary level of IL-lra amoing the patients with IgAN, patients with HSPN and healthy subjects（ P 〉0.05）. The urinary level of IL-1β in the patients with HSPN or IgAGN was significantly higher than that in the healthy subjects （ P 〈 0. 01）. IL-lra/IL-1β ratio in the patients with HSPN or IgAGN was significantly lower than that in the healthy subjects （ P 〈0. 05）. The urinary level of MCP-1 in the patients HSPN or IgAGN was significantly higher than that in the healthy subjects （ P 〈0. 01 or P 〈 0. 05）. The level of MCP-1 in the patients with HSPN was significantly higher than that in the patients with IgAGN （ P 〈0. 01）. The urinal levels IL-lra and IL-1β and IL-lra/IL-1β ratio were not correlate with 24-hour urine total protcin（UTP） （r = 0. 038,r = 0. 023,r = 0. 15, P 〉0.05）. However, MCP-1 level in urine was positively correlated with 24- hour UTP（r = 0. 48, P 〈 0.05）. Conelusions The urinary levels of IL-lra, IL-1β and MCP-1 in the patrents with HSPN were incompletely identical with those in the in patients with IgAGN. The detection of IL-lra,IL-1β and MCP-1 in the urine of the patients with HSPN or IgAGN may be used as a clinical index to reflect immuno inflammatory cell infiltration levels in the kidney,and it also indicates that nephropathia and activity and development of the disease in the patients with HSPN or IgAGN.