过敏性紫癜患儿血清胰岛素样生长因子及胰岛素样生长因子结合蛋白-3的变化

Serum levels of insulin-like growth factor-1 and insulin-like growth factor-binding potein-3 inHenoch-Scholdein purpura

目的探讨胰岛素样生长因子（IGF）-1及胰岛素样生长因子结合蛋白（]GFBP）-3在过敏性紫癜（HSP）中的作用。方法采用放射免疫法方法测定45例HSP患儿不同时期的血清IGF-1及IGFBP-3、C反应蛋白（CRP）水平。采用t检验和直线相关关系。结果HSP急性发作组血清IGF-1[（452±183）μg/L]、IGFBP-3[（13897±3]24）μg/L]及CRP[（20±8）mg／L]水平升高，与健康对照组和缓解组比较，差异均有统计学意义（f值分别为3．42、4．10、11．17、11．63、8．59、9．86，P均〈0．01）；HSP缓解组血清IGF-1、IGFBP-3及CRP与健康对照组比较，差异无统计学意义（t=O．44、0．34、0．52，P均〉0．05）。HSP急性期并发肾损害组血清IGF-1[（621±253）μg／L]、IGFBP-3[（18763±3173）μg／L]水平升高，与无肾损害组比较，差异有统计学意义（t值分别为4-21、7．26，P均〈0．01），有胃肠道症组血清IGF-1[（479±192）μg/L]、IGFBP-3[（13986±3162）μg／L]水平与无胃肠道症状组比较，差异无统计学意义（t值分别为0．83、0．16，P均〉0．05）；血清CRP水平在肾损害组与非肾损害组及胃肠道症组与无胃肠道症状组间差异均无统计学意义（t值分别为0．56、0．32，P均〉0．05）。HSP急性期患儿血IGF-l、IGFBP-3与CRP浓度之间呈直线正相关（r值分别为0．624，0．672，P均〈0．01）。结论IGF-1、IGFBP-3参与了HSP疾病的病理生理过程，血清IGF-1、IGFBP-3测定对紫癜性肾损害的诊断、病情监测及预后判断有一定帮助。

Objective To investigate the role of serum Insulin-like growth factor （IGF）-I, insulinlike growth factor-binding potein （IGFBP）-3 in children with Henoeh-Schonlein purpura （HSP）. Methods The serum concentration of IGF-1, IGFBP-3 was measured by enzyme-linked immunosorbent assay （ELISA） method in 45 acute SHP patients, 40 recovery patients and 30 healthy controls. Results The serum levels of IGF-1 [ （452±183） μg/L], IGFBP-3 [ （ 13 897±3124）μg/L] and C-reactive protein （CRP） [ （20±8） mg/L] in acute phase were significantly higher than those in healthy controls （P〈0.01） and higher than those during recovery period. The serum level of IGF-1, IGFBP-3 for the HSP patients dropped back slowly and their levels during recovery period were the same as those in healthy controls （P〉0.05）. The serum levels of IGF-1 [ （621±253） μg/L] and IGFBP-3 [ （18 763±3173） μg/L ] were higher in the renal damage group than in the non-renal damage group （P〈0.01）, and the same in patients with gastrointestinal symptoms group as in patients without gastrointestinal symptoms group （P〉O.05）, whereas the serum level of CRP was not signi- ficantly different （P〉0.05）. The serum levels of IGF-1, IGFBP-3 showed positive correlation with the level of CRP （r=0.624, 0.672, P〈O.01 ）. Conclusion The IGF-1 and IGFBP-3 may play an important role in the pathological mechanism of HSP. The level of IGF-1 may be used as an indicator for HSP disease activity and progression. IGF-1 may have a close relation with the damage of renal system in HSP.