血和尿胰岛素样生长因子-1水平与过敏性紫癜患儿肾损害的关系

Relationship between serum and urine levels of insulin- like growth factor-1 and renal damage in children with allergic purpura

目的研究尿和血胰岛素样生长因子-1(IGF-1)以及血清胱抑素C(CysC)水平变化在过敏性紫癜(HSP)和紫癜性肾炎(HSPN)中的意义。方法选取HSP患儿30例(HSP组)、HSPN患儿30例(HSPN组)和健康儿童30例(对照组),分别采集尿和血,用化学发光法检测各组标本IGF-1浓度;同时用全自动生化仪检测各组患儿血清CysC、BUN、SCr水平。结果 1HSPN组和HSP组尿和血IGF-1的水平均高于对照组,差异均有统计学意义(P<0.05)。2HSP组和HSPN组血清CysC水平均高于对照组,差异有统计学意义(P<0.05)。3采用直线相关分析HSPN组的血清CysC水平与尿和血IGF-1水平比较,存在正相关(r=0.759、r=0.906,均P<0.05),尿IGF-1与血IGF-1水平也存在正相关(r=0.661,P<0.05)。结论 IGF-1为HSPN发病过程中促发因素,检测尿和血IGF-1水平可作为过敏性紫癜早期肾损害的评价指标。

Objective To study the significance of urine and serum insulin- like growth factor 1（ IGF- 1） and serum cystatin C（ CysC） levels in Henoch- Schonlein purpura（ HSP） and Henoch- Schonlein purpura nephritis（ HSPN）. Methods Thirty HSP patients,25 HSPN patients and 30 healthy children（ control group） were selected for the study. IGF- 1 concentration of specimens in each group was detected by chemiluminescence method; at the same time,the levels of serum BUN,SCr and CysC were detected by automatic biochemistry analyzer. Results Urine and blood IGF- 1 levels in HSP group and HSPN group were significantly higher than the control group（ P〈0. 05）. Serum CysC levels in HSP group and HSPN group were significantly higher than the control group（ P〈0. 05）. The linear correlation analysis showed that serum CysC levels were positively correlated with urine and blood IGF- 1 levels in HSPN group（ r = 0. 759 and r = 0. 906,respectively; all P〈0. 05）;and the levels of urine IGF- 1 and blood IGF- 1 were positively correlated（ r = 0. 661,P〈0. 05）. Conclusion Urine and blood IGF- 1 can be used as the indicator for early renal damage in Henoch- Schoenlein purpura. The study suggests that IGF- 1 may promote the development of HSPN.