原发性肾病综合征患儿血清可溶性髓样细胞触发受体-1和可溶性尿激酶型纤溶酶原激活物受体水平检测的临床意义

Clinical Significance of Serum Levels of Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Soluble Urokinase Type Plasminogen Activator Receptor in Children with Primary Nephrotic Syndrome

目的:探讨原发性肾病综合征(PNS)患儿血清可溶性髓样细胞触发受体-1(sTREM-1)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平与肾病病理类型和肾损伤的关系。方法:将124例在江南大学附属医院儿科接受治疗的PNS患儿作为观察组,同时选取30例健康儿童为对照组。根据病理类型,将观察组分为局灶性节段性肾小球硬化(FSGS)组35例、系膜增生性肾小球肾炎(MsPGN)组41例、膜性肾病(MN)组27例、肾小球微小病变型(MCD)组21例;根据有无急性肾损伤,将观察组分为肾损伤组33例和非肾损伤组91例。检测受试者血清sTREM-1、suPAR水平,并分析其与PNS病理类型和肾脏损伤的关系。结果:观察组sTREM-1、suPAR、总胆固醇(TC)、甘油三酯(TG)、血肌酐(Scr)、尿酸(UA)、24 h尿蛋白(24hUp)、尿N-乙酰-β-氨基葡萄糖苷酶(uNAG)、尿微球蛋白(uβ2-MG)水平高于对照组,血清蛋白(ALB)水平低于对照组(P均<0.05)。肾损伤组血清sTREM-1、suPAR高于非肾损伤组(P均<0.05);MsPGN组、MN组、MCD组血清sTREM-1、suPAR水平比较差异无统计学意义(P均>0.05),且均低于FSGS组(P均<0.05)。血清sTREM-1、suPAR与TC、TG、24hUp、uNAG及uβ2-MG呈正相关,而与ALB呈负相关(P均<0.05)。结论:PNS患儿血清sTREM-1、suPAR水平显著上升,且可在一定程度上反映PNS病理类型和肾功能。

Objective:To investigate the correlation between serum levels of soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and soluble urokinase type plasminogen activator receptor(suPAR)in children with primary nephrotic syndrome(PNS)and pathological types and renal damage.Methods:A total of 124 children with PNS admitted into Affiliated Hospital of Jiangnan University were extracted as the observation group,while 30 healthy children were selected as the control group.According to pathological types,patients in the observation group were divided into the focal segmental glomerulosclerosis group(FSGS group,n=35),the mesangial proliferative glomerulonephritis group(MsPGN group,n=41),the membranous nephropathy group(MN group,n=27)and the glomerular minimal change disease group(MCD group,n=21).According to the presence or absence of acute renal injury,patients in the observation group were divided into the renal injury group(n=33)and the non-renal injury group(n=91).The serum levels of sTREM-1 and suPAR were measured,and the correlation with pathological types of PNS and renal injury was analyzed.Results:Levels of sTREM-1,suPAR,total cholesterol(TC),triglyceride(TG),serum creatinine(Scr),uric acid(UA),24-hour urinary protein(24hUP),urinary n-acetyl-β-glucosaminidase(uNAG),urinary microglobulin(uβ2-MG)in the observation group were higher than those in the control group(P<0.05),and serum protein(ALB)were lower than those in the control group(P<0.05).Serum levels of sTREM-1 and suPAR in the renal injury group were higher than those in the non-renal injury group(P<0.05);there was no statistically significant difference in serum levels of sTREM-1,suPAR among MsPGN group,MN group and MCD group(P>0.05),which were lower than those of the FSGS group(P<0.05).Serum levels of sTREM-1 and suPAR were positively correlated with TC,TG,24hUP,uNAG and uβ2-MG(P<0.05),and negatively correlated with ALB(P<0.05).Conclusion:The serum levels of sTREM-1,suPAR in children with PNS increased significantly,which could reflect the pathological types of PNS and renal function to a certain extent.