过敏性紫癜、紫癜性肾炎患儿血清VEGF、TNF-α水平变化及临床意义

Changes and clinical significance of vascular endothelial growth factor and tumor necrosis factor-α in children with Henoch-Schonlein purpura

目的:探讨过敏性紫癜(HSP)、紫癜性肾炎(HSPN)患儿血清血管内皮生长因子(VEGF)及肿瘤坏死因子-α(TNF-α)的水平变化及其在HSP发病与肾损害严重程度中的作用。方法:采用酶联免疫吸附法分别检测38例HSP患儿、40例HSPN及16例正常儿童血清VEGF、TNF-α水平;HSPN患儿同时测定血清尿素氮、肌酐、尿微量白蛋白(MA)和24 h尿蛋白定量,分析血清VEGF、TNF-α浓度与上述指标的相关关系。结果:①HSP、HSPN患儿血清VEGF、TNF-α浓度均高于正常儿童(P<0.05)。②HSPN患儿其血清VEGF、TNF-α浓度高于HSP组(P<0.05)。③HSPN组的血清VEGF、TNF-α与尿MA及24 h尿蛋白定量呈正相关关系(P<0.05)。④肾活检显示,血浆VEGF、TNF-α水平与肾脏病理损害、血管损害呈正相关。结论:VEGF和TNF-α在儿童HSP的发生与发展中发挥一定的作用,血清VEGF和TNF-α浓度动态变化对临床小儿HSPN的病情判断、疗效及预后评价具有一定的指导意义。

Objective： To investigate the level changes of vascular endothelial growth factor（VEGF） and tumor necrosis factor-α （TNF-α） in children with Henoch-Schonlein purpura and the effect of VEGF and TNF-α in kidney impairment. Methods： The changes of VEGF and TNF-α were measured in 38 cases HSP patients,40 cases HSPN patients and 16 controls. Results： ①The concentration of VEGF and TNF-α in paitents were much higher than normal control group （P〈 0.05）. ②The concentration of VEGF and TNF-α in children with HSPN were higher than that in children with HSP （P〈 0.05）.③The concentration of VEGF and TNF-α were positively correlated with the severity of pathological and vascular impairment in kidney （P〈0.05）. ④Renal biopsy showed that plasma VEGF and TNF-α had positively correlated relationship with renal pathological lesion and vessel damage. Conclusion： ①VEGF and TNF-α play important roles in the development of HSP in children. ②Changes of VEGF and TNF-α concentration may be used to assess the severity of pathological and vascular impairment in children with HSPN.