新型尿液标志物在紫癜性肾炎患儿中的水平变化

Changes of new urinary biomarkers in children with Henoch-Schonlein purpura nephritis

目的·研究尿血管紧张素原(urinary angiotensinogen,UAGT)、尿成纤维细胞特异蛋白-1(fibroblast-specific protein-1,FSP-1)及尿凝血酶在紫癜性肾炎(Henoch-Schonlein purpura nephritis,HSPN)患儿中的水平变化。方法·选取HSPN患儿(HSPN组,n=14)、过敏性紫癜(Henoch-Schonlein purpura,HSP)未合并肾脏受损患儿(HSP组,n=28)和尿检正常儿童(对照组,n=23);同时选取不同治疗阶段的HSPN患儿,包括未治疗组(n=10)、完成糖皮质激素(glucocorticoid,GC)冲击治疗组(GC组,n=9)和完成GC联合环磷酰胺(cyclophosphamide,CTX)序贯冲击治疗组(GC+CTX组,n=8)。收集以上患儿的一般临床资料及新鲜晨尿标本,运用试剂盒检测尿中UAGT、FSP-1及凝血酶水平,并测定尿肌酐(urinary creatinine,Ucr)用于校正。结果·HSPN组患儿UAGT/Ucr及FSP-1水平显著高于HSP组及对照组(均P<0.05);HSPN组患儿尿凝血酶水平与HSP组间差异无统计学意义,但2组水平均显著高于对照组(均P<0.05)。HSPN未治疗组患儿UAGT/Ucr水平与GC组间差异无统计学意义,但显著高于GC+CTX组(P=0.000);未治疗组尿FSP-1水平显著高于GC组(P<0.05),但与GC+CTX组间差异无统计学意义;尿凝血酶水平在HSPN患儿的3个组间差异无统计学意义。结论·UAGT/Ucr、FSP-1和凝血酶水平在HSPN患儿尿液中均明显升高,且UAGT/Ucr和FSP-1可能对患儿的疗效有一定的提示作用。

Objective·To evaluate the changes of urinary angiotensinogen(UAGT),fibroblast-specific protein-1(FSP-1)and thrombin in the children with Henoch-Schonlein purpura nephritis(HSPN).Methods·Fourteen children with HSPN(HSPN group),28 children with Henoch-Schonlein purpura(HSP)but without renal injury(HSP group)and 23 children with normal urinalysis(control group)were included in the study.Ten HSPN children before treatment(untreated group),9 HSPN children after glucocorticoid(GC)pulse therapy(GC group)and 8 HSPN children after GC and cyclophosphamide(CTX)double pulse therapy(GC+CTX group)were also selected in the study.Clinical information and fresh morning urine samples were collected from all the children.UAGT,FSP-1 and thrombin in urine were measured by kits.Urine creatinine(Ucr)was also measured for correction.Results·UAGT/Ucr and FSP-1 in HSPN group were significantly higher than those in HSP group and control group(P<0.05).Thrombin in HSPN group had no significant difference,compared with HSP group(P>0.05),but thrombin levels in HSPN group and HSP group were both significantly higher than that in control group(P<0.05).UAGT/Ucr in HSPN untreated group had no significant difference,compared with GC group,while it was significantly higher than that in GC+CTX group(P=0.000).FSP-1 in untreated group was significantly higher than that in GC group,but had no significant difference,compared with GC+CTX group.There was no significant difference in thrombin among the 3 HSPN groups.Conclusion·UAGT/Ucr,FSP-1 and thrombin all increase in the urine of HSPN children,and UAGT/Ucr and FSP-1 may reflect the treatment effect to some extent.