摘要
目的:探讨紫癜性肾炎(HSPN)患儿的血清、尿液可溶性血管细胞黏附分子-1(sVCAM-1)水平变化及临床意义。方法:过敏性紫癜(HSP)患儿50例,按有无肾脏累及分为HSPN组(30例)和HSP无肾受累(NO-HSPN)组(20例);正常对照组20例。应用ELISA法检测各组血清、尿液sVCAM-1水平,进行比较,并分析其与主要临床指标(包括24 h尿蛋白、尿红细胞)的关系。结果:HSPN组和NO-HSPN组的血清sVCAM-1水平[分别为(809.79±173.32)ng/ml、(623.44±67.27)ng/ml]均高于对照组(494.79±59.84)ng/ml,P<0.01,HSPN组的血清sVCAM-1水平高于NO-HSPN组(P<0.01)。HSPN组的尿液sVCAM-1水平(121.24±110.83)ng/ml高于对照组(20.61±16.76)ng/ml和NO-HSPN组(19.37±12.93)ng/ml,P均<0.01,NO-HSPN组的尿液sVCAM-1水平与对照组比较,无统计学差异(P>0.05)。HSPN患儿中,蛋白尿组高于无蛋白尿组(P均<0.01),肾病蛋白尿组高于蛋白尿组(P均<0.05)和无蛋白尿组(P均<0.01);肉眼血尿组的血清sVCAM-1水平高于无血尿组,与镜下血尿组比较无统计学差异(P>0.05);镜下血尿组的血清sVCAM-1浓度高于无血尿组(P<0.01);镜下血尿组和肉眼血尿组的尿液sVCAM-1水平明显高于无血尿组(P均<0.05),镜下血尿组和肉眼血尿组之间无统计学差异(P>0.05)。HSPN患儿的血清和尿液sVCAM-1水平均与24 h尿蛋白量和尿红细胞量呈显著性正相关(P均<0.01)。结论:VCAM-1可能参与了HSPN的发生、发展过程;尿液sVCAM-1的检测在监测肾脏损害方面具有较好的临床实用价值。
Objective:To explore the concentration of ,soluble vascular cellular adhesion molecule- 1 (sVCAM- 1 ) in serum and urine in children with Henoch- Schonlein purpura nephritis(HSPN) and explore its clinical significance. Methods:There were 50 patients with HSP in the study. They were divided into two groups according to their renal lesions:30 cases with HSPN and 20 cases without HSPN(as NO-HSPN group). The control group included 20 healthy children. The concentration of sVCAM- 1 in serum and urine of all children were detected by enzymelinked immunosorbent assay( ELISA). Then we compared the concentrations in every group and analyzed the relationship between the concentrations of sVCAM - 1 and the main clinical markers (including 24 hours urinary protein and urinary erythrocyte). Results: The serum concentrations of sVCAM- 1 in HSPN group (809.79 ±173.32) ng/ml and NO- HSPN group (623.44 ±67.27)ng/ml were both significantly higher than those in the control group ( 494.79 ±59.84)ng/ml (P〈 0.01 ). The serum concentration of sVCAM- 1 in HSPN group was significantly higher than that in NO- HSPN group (P〈0.01). The urinary concentration of sVCAM- 1 in HSPN group were significantly higher than those in NO- HSPN group (P〈 0.01 ) and the control group (P〈 0.01), but there was no significant difference between the NO- HSPN group and the control group (P 〉 0.05). The concentration of VCAM - 1 in the proteinuria group was significantly higher than that in the no-proteinuria group (P〈 0.01 ). The concentration of VCAM- 1 in the nephropathy proteinuria group was significantly higher than those in the proteinuria group (P 〈 0.05) and the no - proteinuria group(P 〈 0.01 ). The serum concentration of sVCAM - 1 in the gross hematuria group was significantly higher than that in the no- hernaturia group (P〈 0.01 ), but was not significantly different from that in the microscopic hematuria group (P 〉 0.05). The serum concentration of sVCAM- 1 in the microscopic hema- turia group was higher than that in the no- hematuria group (P 〈 0.01 ) too. The urinary concentrations of sVCAM- 1 were different in the groups with different levels of hematuria, because sVCAM- 1 levels were significantly higher in the grass hematuria group and the microscopic hematuria group than that in the no-hematuria group (P 〈 0.05). But it was not significantly different between the microscopic hematuria group and the gross hematuria group (P 〉 0.05). There was a significantly positive correlation between the concentration of sVCAM - 1 both in serum and in urine and the level of 24 hours urinary protein and urinary erythrocyte too (P 〈 0.01). Conclusion: It suggest that VCAM- 1 is involved in the course of the onset and the development of HSPN. The sVCAM- 1 in urine is worthy of detection for monitoring the renal lesions.
出处
《中国中西医结合肾病杂志》
2009年第1期39-41,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
温州市科技局基金资助项目(No.Y20060116)
关键词
紫癜性肾炎
血管细胞黏附分子-1
儿童
Henoch- Schonlein purpura nephritis(HSPN) Vascular cdlular adhesion molecule- 1 (VCAM- 1) Children