中性粒细胞明胶酶相关脂质运载蛋白、尿胱抑素C水平联合检测对肾功能评价的临床意义

Value of NGAL,Cystatin C and Immunoglobulin Ievels in Childhood Henoch-Schonlein Purpura

目的:探讨中性粒细胞明胶酶相关脂质运载蛋白、胱抑素C和免疫球蛋白水平检测在儿童过敏性紫癜(HSP)早期肾损害诊断中的应用价值及相关性。方法:将60患儿分为HSP普通型组30例、HSP肾型组30例,另随机选择同期门诊体检儿童60例为对照组,检测受试者血浆NGAL、尿胱抑素和免疫球蛋白(IgA、IgM、IgG)的水平。结果:3组患儿NGAL、胱抑素C和IgA水平比较,差异有统计学意义(P<0.05);3组IgM、IgG之间比较,差异无统计学意义(P>0.05)。HSP肾型组较NGAL、胱抑素C和IgA含量高于对照组,差异有统计学意义(X2=22.4,28.3,19.7,P<0.05);HSP肾型组NGAL、胱抑素C和IgA含量高于HSP普通型组,差异有统计学意义(X2=25.7,32.6,22.1,P<0.05)。NGAL与胱抑素C呈正相关(r=12.36,P<0.05);NGAL与IgA呈正相关(r=17.01,P<0.05);胱抑素C与IgA呈正相关(r=22.25,P<0.05)。结论:NGAL、胱抑素和免疫球蛋白水平对于HSP的诊断具有一定的价值,尤其对患儿肾功能早期损害的诊断,早期联合检测三者的水平,适时地给予预防性治疗,对保护HSP患儿的脏器功能、改善预后具有重要的临床意义。

Objective： To discuss the application value of and correlation among the detection of NGAL, Cystatin C and immunoglobulin levels in the diagnosis of early kidney injury in Henoch-Schonlein Purpura patients. Methods： 60 patients with HSP were divided into HSP normal type group （30 cases） and HSP kidney injury type group （30 cases）. 60 physical examination children were randomly chosen as control group. Result： Levels ofNGAL, Cystatin C and IgA among the three groups showed statistically significant difference （P〈0.05）. Ig（3 and IgM levels among the three groups showed no statistically significant difference （P〉0.05）; the levels of NGAL, Cystatin C and IgA in the two HSP groups were statistically increased compared with the control group（XZ=22.4, 28.3, 19.7, P＇〈 0.05）. The levels ofNGAL, Cystatin C and IgA in HSP kidney injury type group were statistically increased compared with HSP normal type group （XZ=-25.7, 32.6, 22.1, P^0.05）. NGAL was positively correlated to Cystatin C （r=12.36, P〈0.05）; NGAL was positively correlated to IgA （r=17.01, P〈0.05）; Cystatin C was positively correlated to IgA （r=22.25, P〈~0.05）. Conclusion： NGAL, Cystatin C and immunoglobulin levels are valuable in the diagnosis of liSP, especially in the patients with early kidney injury. Detection of these indexes at early stage and timely prevention treatment is important to protect the organ functions and improve the prognosis.