儿童过敏性紫癜早期肾上腺皮质激素治疗中尿微量蛋白的变化及意义

Clinical Significance of Urine Microprotein in Henoch-Schonlein Purpura in Children by Early Use of Prednisone

目的:通过对观测尿液微量蛋白的变化,探讨在儿童过敏性紫癜早期使用肾上腺皮质激素治疗的临床意义。方法:对入选的214例HSP患儿随机分为激素治疗组和非激素治疗组。分别在治疗前,治疗第七天采用放射免疫法对尿微量白蛋白(mALb),α1微球蛋白(α1-MG),β2微球蛋白(β2-MG)进行测定,并设定健康儿童为对照组。结果:治疗前HSP患儿mALb,β2-MG及α1-MG较健康儿童对照组明显升高。在治疗第七天后激素治疗组与非激素治疗组相比较mALb,β2-MG及α1-MG均有所下降;激素治疗组与正常对照组相比较mALb,α1-MG明显下降;非激素治疗组与健康儿童对照组相比较mALb,β2-MG及α1-MG均仍是升高。结论:尿微量蛋白的检测可全面、早期、敏感地反映HSP患儿肾脏受损情况。早期使用皮质激素治疗可减轻或减缓肾脏的受损,可能也是临床上阻断紫癜性肾炎(HSPN)的发生的一个途径。

Objective：Objective Clinical research into HSP in children by early prednisone treatment through investigating Changes of urine microprotein.Methods：214 children with HSP were divided into prednisone treatment group and non-prednisone treatment group randomly.Respectively,the urine microprotein mALb,β2-MG and α1-MG examined by using radioimmunoassay before prednisone treatment and after 7 days.Results：Before the prednisone treatment,the level of mALb,β2-MG and α1-MG in 214 children with HSP increased significantly compared with normal children.After prednisone treatment,in the prednisone treatment group the level of mALb,β2-MG and α1-MG decreased significantly compared with non-prednisone treatment group（P〈0.05）;in the non-prednisone treatment group,the level of mALb,β2-MG and α1-MG increased significantly compared with normal children（P〈0.05）.Conclusion：Renal early injury of HSP in children can be detected by urine microprotein examination and reduced by early prednisone treatment.Early prednisone treatment may be the way to reduce the incidence of HSPN.