Gd-IgA1和NGAL检测在儿童紫癜性肾炎早期诊断中的应用价值

Application Value of Gd-IgA1 and NGAL in the Early Diagnosis of Henoch-Sch nlein Purpura Nephritis in Children

目的探讨半乳糖缺乏IgA1(Gd-IgA1)和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的检测在儿童紫癜性肾炎(HSPN)早期诊断中的应用价值。方法选取初发过敏性紫癜(HSP)患儿50例,按入院后是否累及肾脏分为无肾炎组(HSP组)31例和肾炎组(HSPN组)19例,另选取同期28例门诊健康检查儿童作为对照组。采用ELISA方法检测各组血清及尿液Gd-IgA1、NGAL水平,采用放射免疫分析法测定尿肌酐(uCr),采用全自动生化分析仪检测血清中尿素(Urea)、血肌酐(sCr)和胱抑素C(CysC)水平。比较3组间各指标的差异,采用受试者工作特征(ROC)曲线分析各指标对HSPN的诊断价值。结果HSP组、HSPN组患儿血清Gd-IgA1、NGAL水平和尿液Gd-IgA1/uCr、NGAL/uCr水平较正常对照组升高(P<0.05),且HSPN组上述指标较HSP组亦显著升高(P<0.05)。血清Gd-IgA1、NGAL、CysC和尿液Gd-IgA1/uCr、NGAL/uCr诊断HSPN的ROC曲线下面积(AUC)分别为0.807、0.767、0.686、0.762和0.775,其中血清Gd-IgA1特异性最高(91.5%),尿液NGAL/uCr敏感度最高(78.9%)。结论血清及尿液Gd-IgA1、NGAL水平检测对早期诊断HSPN有指导意义。

Objective To explore the application value of the detection of galactose-deficient IgA1(Gd-IgA1)and neutrophil gelatinase-associated lipocalin(NGAL)in the early diagnosis of Henoch-Sch nlein purpura nephritis(HSPN)in children.Methods Fifty children diagnosed with Henoch-Schonlein PurPura for the first time were selected.According to whether the kidneys were involved after hospitalization,31 cases were divided into the non-nephritis group(HSP group)and 19 cases were divided into the nephritis group(HSPN group),and 28 outpatient health examination children during the same period were selected as the control group.ELISA method was used to detect serum and urine Gd-IgA1 and NGAL levels,radioimmunoassay method was used to determine urine creatinine(uCr),and automatic biochemical analyzer was used to detect serum urea(Urea),blood creatinine(sCr)and Cystatin C(CysC)level.The differences of the indicators between the three groups were compared,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of each indicator to HSPN.Results The levels of serum Gd-IgA1,NGALand urine Gd-IgA1/uCr,NGAL/uCr levels of children in the HSP group and HSPN group were higher than those in the normal control group(P<0.05),and the above indicators in the HSPN group were significantly higher than those in the HSP group(P<0.05).The area under the ROC curve(AUC)of serum Gd-IgA1,NGAL,CysC and urine Gd-IgA1/uCr,NGAL/uCr to diagnose HSPN are 0.807,0.767,0.686,0.762,0.775.Among them,serum Gd-IgA1 has the highest specificity(91.5%),and urine NGAL/uCr had the highest sensitivity(78.9%).Conclusion The detection of serum and urine Gd-IgA1 and NGAL levels has guiding significance for the early diagnosis of HSPN.