EGF、PAF-AH对过敏性紫癜肾脏损害的临床诊断意义

The clinical diagnosis significance of EGF and PAF-AH on henoch-schonlein purpura renal damage

目的探讨表皮生长因子(EGF)、血小板活化因子酰水解酶(PAF-AH)与过敏性紫癜(HSP)肾脏损害的关联性及临床诊断意义,为临床早期诊断紫癜性肾炎(HSPN)及判断预后提供一种新思路。方法收集2013年9月至2014年1月在宁夏医科大学总院住院的HSP患儿86例,病例组按有无肾脏损害将其分为非HSPN组和HSPN组。健康儿童50例为健康对照组,支气管肺炎30例为肺炎对照组。PCR检测血EGF、PAF-AH的表达水平变化;ELISA检测血EGF、PAF-AH及尿EGF的水平变化。结果检测血PAF-AH、EGF mRNA,病例组较健康对照组明显升高,HSPN组血PAF-AH mRNA较非HSPN组亦升高,差异均有统计学意义(P<0.05);病例组较肺炎对照组血PAF-AH明显升高,差异有统计学意义(P<0.05)。HSPN组血EGF mRNA较非HSPN组升高,但差异无统计学意义(P>0.05)。病例组血PAF-AH、EGF和尿EGF较健康对照组明显升高,且病例组恢复期较急性期明显降低(P<0.05)。结论血EGF、PAF-AH及尿EGF参与HSP的发病过程,并且与肾脏损害有相关性。

Objective To explore the correlation and clinical diagnostic significance between EGF,PAF-AH on henochschonlein purpura（HSP）renal damage in children,in order to provide a new way of thinking for early diagnosis and clinical prognosis for HSP nephritis（HSPN）.Methods Totally 86 cases of children with HSP from September 2013 to January 2014 in hospital were collected.According to the presence of renal damage,the patients were divided into non-HSPN group and HSPN group,50 cases of healthy children as control group,and 30 casea were diagnosied as ＂ bronchial pneumonia＂.Using PCR technique to detect the change of blood EGF and PAF-AH,and using ELISA to detect the change of blood EGF,PAF-AH and urine EGF.Results Detection of blood PAF-AH mRNA,EGF mRNA in case group obviously higher than control group,and detection of blood PAF-AH mRNA in HSPN group were also hgher than non-HSPN group（P〈0.05）.Detection of blood EGF mRNA in HSPN group higher were than non-HSPN group,but there was no statistically significant difference（P〉0.05）.Detection of serum PAF-AH,EGF and urine EGF in case group obviously higher than control group and the case group significantly lower recovery than acute stage（P〈0.05）.Conclusion Blood EGF,PAF-AH and urine EGF process involved in the pathogenesis of HSP,and is related to renal damage.