尿IGF-1、ET-1、TGF-β_1、MCP-1水平在肾积水患儿中的变化及临床意义

Changes of urinary IGF-1, ET-1, TGF-β_1 and MCP-1 levels in children with hydronephrosis and their clinical significance

目的观察肾积水患儿尿IGF-1、ET-1、TGF-β_1、MCP-1水平的变化,并分析其临床意义。方法选取57例肾积水患儿作为肾积水组,另选取同时段健康体检儿童30例作为健康对照组。比较两组的IGF-1、ET-1、TGF-β_1、MCP-1水平,并分析肾积水患儿上述指标水平与病理分级之间的关系。结果肾积水组不同病理分级患儿的尿IGF-1水平均低于健康对照组,ET-1、TGF-β_1及MCP-1水平均高于健康对照组(P<0.05)。肾积水组患儿的病理分级与尿IGF-1水平呈高度负相关(r=-0.912,P<0.01),与尿MCP-1水平呈高度正相关(r=0.812,P<0.01);肾积水组患儿病理分级与ET-1、TGF-β_1水平呈正相关,但差异无统计学意义(P>0.05)。结论肾积水患儿尿IGF-1、ET-1、TGF-β_1、MCP-1水平可作为评价肾脏损害的指标,其中IGF-1、MCP-1可客观、准确评估肾积水患肾肾功能损害程度,可作为判断病肾损害程度的敏感性指标。

Objective To observe the changes of urinary IGF-1, ET-1, TGF-β1 and MCP-1 levels in children withhydronephrosis and to analyze their clinical significance. Methods Fifty-seven children with hydronephrosis were selectd ashydronephrosis group, and 30 healthy children received healthy examination at the same period were selectd as healthycontrol group. The levels of urinary IGF-1, ET-1, TGF-β1 and MCP-1 were compared between the two groups, and therelationships between above indicators levels and pathological grading were analyzed. Results The levels of urinary IGF-1in different pathological grades of the hydronephrosis group were lower than that of the healthy control group, and thelevels of urinary ET-1, TGF-β1 and MCP-1 were higher than those of the healthy control group（P〈0.05）. The pathologicalgrade of the hydronephrosis group was negatively correlated with urinary IGF-1 level（r=-0.912, P〈0.01）, and positivelycorrelated with urinary MCP-1 level（r=0.812, P〈0.01）. The pathological grade of hydronephrosis group was positivelycorrelated with the levels of ET-1 and TGF-β1, but there were no significant differences（P〉0.05）. Conclusion The urinaryIGF-1, ET-1, TGF-β1 and MCP-1 levels in children with hydronephrosis can be used as indicators for evaluating renalimpairment. Among them, IGF-1 and MCP-1 can objectively and accurately evaluate the degree of renal impairment inchildren with hydronephrosis, and can be used as sensitive indicators for judging the degree of renal impairment.