对ANCA相关性AASV合并肾损害患者进行血浆及尿液中VEGF检测的意义

The significance of VEGF detection in plasma and urine in patients with ANCA-associated AASV with renal impairment

目的:分析对抗中性粒细胞胞浆抗体(ANCA)相关性系统性小血管炎(AASV)合并肾损害患者进行血浆及尿液中血管内皮细胞生长因子(VEGF)检测的临床意义。方法:选取近年来在西南医科大学附属医院就诊的25例ANCA相关性AASV合并肾损害患者(为研究组)及同期在该医院接受健康体检的25例健康人(为对照组)为研究对象。在两组受检人员入院后,均使用超敏免疫组化二步法和酶联免疫吸附试验(ELISA)对其进行血浆及尿液VEGF的检测,然后对比、分析其检测的结果。结果:与对照组受检人员相比,研究组患者血浆及尿液VEGF的水平均较高,P<0.05。接受治疗后研究组患者血浆及尿液中VEGF的水平均明显低于接受治疗前,P<0.05。ANCA相关性AASV患者的病情与其血浆、尿液中VEGF的水平呈正相关,与其ANCA定量、血尿程度、24 h尿蛋白定量、CRP及SCr的水平等均无相关性。结论:ANCA相关性AASV合并肾损害患者血浆及尿液中VEGF的水平可显著升高。对该病患者使用环磷酰胺及糖皮质激素进行治疗可明显降低其血浆及尿液中VEGF的水平。对ANCA相关性AASV患者进行血浆及尿液VEGF的检测可帮助临床上判断其病情的严重程度。

Objective： To analysis against neutrophil cytoplasm antibodies（ANCA） associated small systemic vasculitis（AASV） with renal damage in plasma and urine in patients with vascular endothelial growth factor（VEGF） in detection of clinical significance. Methods： in recent years in affiliated hospital of southwest medical university 25 cases ANCA associated AASV merger（group） and patients with renal damage in the hospital for physical examination of 25 cases of healthy people（control group） as the research object. Gien the two groups after admission, all use allergic immunohistochemical two footwork and enzyme-linked immunosorbent assay（ELISA） in plasma and urine of VEGF, then contrast and analysis of the test results. Results： compared with the control group, the plasma and urine VEGF levels were higher in the study group, P〈0.05. After treatment, VEGF levels in plasma and urine were significantly lower in the study group than before treatment, P〈0.05. The condition of patients with ANCA related AASV was positively correlated with VEGF level in plasma and urine, and was not correlated with ANCA quantitative, hematuria degree, 24-hour urinary protein quantitative, CRP and SCr levels. Conclusion： VEGF levels in plasma and urine of patients with ANCA-associated AASV with renal impairment were significantly increased. Treatment with cyclophosphamide and glucocorticoid can significantly reduce VEGF levels in plasma and urine. The detection of VEGF in plasma and urine in ANCA-associated AASV patients can help clinically determine the severity of their disease.