血清及尿液单核细胞趋化蛋白1检测在过敏性紫癜肾炎患儿诊断中的价值比较

The Value Comparison of Serum and Urine MCP-1 Detection in Diagnosis of Children with Henoch-Schonlein Purpura Nephritis

目的比较血清及尿液单核细胞趋化蛋白1(MCP-1)检测在过敏性紫癜肾炎(HSPN)患儿诊断中的临床价值。方法选取淮安市肿瘤医院2008年2月至2012年10月住院治疗的78例过敏性紫癜肾炎患儿,根据尿白蛋白排泄率(UAER)分为正常白蛋白尿组(A组,27例),微量白蛋白尿组(B组,25例),大量白蛋白尿组(C组,26例),根据疾病病情分为缓解期(n=36例),急性期(n=42例),比较各组血清及尿液MCP-1表达水平及其与尿蛋白排泄率(UAER)的相关性。结果随UAER增加各组尿液MCP-1表达水平呈明显递增趋势(P<0.05),而各组血清MCP-1表达水平比较,差异无统计学意义(P>0.05);急性期尿液MCP-1表达水平显著高于缓解期(P<0.05);缓解期及急性期HSPN患儿血清MCP-1表达水平比较,差异无统计学意义(P>0.05);HSPN患儿尿液MCP-1表达水平与UAER呈正相关(r=0.782,P<0.05),HSPN患儿血清MCP-1表达水平与UAER无相关(r=0.327,P>0.05)。结论尿液MCP-1表达水平与HSPN患儿肾脏组织病变程度和尿蛋白有着密切相关性,对HSPN患儿疾病预后情况判断和临床治疗方案指导有着十分重要的意义。

Objective To compare the clinical value of serum and urine monocyte chemoattractant protein-1（ MCP-1） detection in diagnosis of children with Henoch-Schonlein purpura nephritis（ HSPN）. Methods A total of 78 cases of children with HSPN according to UAER were divided into normal albuminuria group（ group A,27 cases）,microalbuminuria group（ group B,25 cases）,macroalbuminuria group（ group C, 26 cases） according to urinary albumin excretion rate（ UAER） and remission phase group（ n = 36 cases）, acute phase group（ n = 42 cases）. The expression level of MCP-1 in serum,urine,and the correlation of MCP-1 level and UAER were compared. Results With the increase of UAER,the expression level of MCP1 in all groups increased（ P 0. 05）,and the serum MCP-1 levels in every group showed no significant difference（ P 0. 05）. The urine MCP-1 levels in acute phase were higher than that of remission phase（ P 0. 05）,but serum MCP-1 levels showed no statistically significant difference between the remissions phase and acute phase（ P 0. 05）. The expression level of urinary MCP-1 in children with HSPN had a positive relationship with UAER（ r = 0. 782,P 0. 05）,but the expression level of serum MCP-1 in children with HSPN had no significant correlation with UAER（ r = 0. 327,P 0. 05）. Conclusion The urinary expression level of MCP-1 is closely correlated with renal tissue lesion degree and urinary protein in children with HSPN, which is of great significance for judging the disease prognosis of HSPN and guiding the clinical treatment.