IGF-1及IGFBP-3在过敏性紫癜及紫癜性肾炎患儿临床检测中的意义

Clinical significance of serum levels of IGF-1 and IGFBP-3 in children with HenochSchonlein purpura or Henoch-Schonlein purpura nephritis

目的探讨胰岛素样生长因子-1(IGF-1)及胰岛素样生长因子结合蛋白-3(IGFBP-3)在过敏性紫癜(HSP)及紫癜性肾炎(HSPN)患儿临床检测中的意义。方法选取31例HSP患儿为HSP组,28例HSPN患儿为HSPN组,另选取31例健康儿童为对照组,采用ELISA法测定各组血清标本的IGF-1及IGFBP-3浓度,全自动生化仪检测HSPN组24 h尿蛋白定量;各组儿童均行血清免疫球蛋白(Ig)水平、补体C3、全血细胞计数检测和尿液分析。结果 HSP组血清IGF-1及IGFBP-3水平均高于对照组(均P<0.05),HSPN组血清IGF-1及IGFBP-3水平均高于HSP组和对照组(均P<0.05);在12例进行肾穿刺活检的HSPN患儿中,随着HSPN病理分级的加重,血清IGF-1及IGFBP-3水平有增高趋势;有蛋白尿的HSPN患儿血清IGF-1及IGFBP-3水平均高于无蛋白尿的HSPN患儿(均P<0.05);HSP和HSPN患儿的白细胞、红细胞、血小板计数、补体C3、IgG和IgA水平以及IgA/C3比值均显著高于对照组(均P<0.05)。结论在HSP急性发作期IGF-1和IGFBP-3水平升高,可能与蛋白尿的程度及肾脏损害程度有关,提示IGF-1和IGFBP-3水平可能是肾脏受累的指示。

Objective To study the clinical significance of serum levels of insulin-like growth factor 1 （IGF- 1） and insulin-like growth factor binding protein 3 （IGFBP-3） in children with Henoch-Schonlein purpura （HSP） or Henoch-Schonlein purpura nephritis （HSPN）. Methods Thirty-one children with HSP were selected as the HSP group, and 28 children with HSPN were selected as the HSPN group. Another 31 healthy children were selected as the control group. ELISA was used to measure serum levels of IGF-1 and IGFBP-3 in each group. Measurement of 24-hour urinary protein excretion was performed using an automatic biochemical analyzer in the HSPN group. Serum immunoglobulin （Ig） levels, complement C3 level and complete blood counts in each group were determined, and urine analysis was also performed. Results Serum levels of IGF-1 and IGFBP-3 in the HSP group were significantly higher than in the control group （P〈0.05）, and serum levels of IGF-1 and IGFBP-3 in the HSPN group were significantly higher than in the HSP and control groups （P〈0.05）. Among 12 children who underwent renal puncture biopsy, patients with higher pathological grades had higher serum levels of IGF-1 and IGFBP-3. In children with HSPN, those with proteinuria had significantly higher serum levels of IGF-1 and IGFBP-3 than those without proteinuria （P〈0.05）. Levels of white cells, red cells, platelet count, complement C3, IgG, and IgA and IgA/C3 ratio were significantly higher in the HSP and HSPN groups than in the control group （P〈0.05）. Conclusions Increased serum levels of IGF-1 and IGFBP-3 are observed in the acute onset period of HSP, which may be related to the degree of proteinuria and renal damage. Serum levels of IGF-1 and IGFBP-3 may be indicators of renal involvement.