sdLDL-C、Cys-C、AT-Ⅲ在儿童原发性肾病综合征中的诊断价值

Diagnostic value of sdLDL-C,Cys-C and AT-Ⅲ in child with primary nephrotic syndrome

目的探讨小而密低密度脂蛋白胆固醇(sdLDL-C)、胱抑素C(Cys-C)、抗凝血酶Ⅲ(AT-Ⅲ)在儿童原发性肾病综合征(PNS)中的诊断价值。方法收集陕西省榆林市绥德县医院儿科2018年1月至2021年6月收治的PNS患儿350例作为观察组,根据临床分型分为单纯型组(250例)、肾炎型组(100例)2个亚组。选取同期健康儿童100例作为对照组。比较所有研究对象的sdLDL-C、Cys-C、AT-Ⅲ水平,并分析以上指标对肾炎型PNS患儿的诊断价值。结果观察组患儿sdLDL-C、Cys-C水平明显高于对照组,AT-Ⅲ水平明显低于对照组,差异均有统计学意义(P<0.05);肾炎型组患儿sdLDL-C水平明显高于单纯型组,AT-Ⅲ水平明显低于单纯型组,差异有统计学意义(P<0.05)。sdLDL-C、AT-Ⅲ联合检测诊断肾炎型PNS患儿的曲线下面积、灵敏度、特异度分别为0.881、90.0%、78.8%,明显高于sdLDL-C、AT-Ⅲ单独检测的诊断效能。结论PNS患儿sdLDL-C、Cys-C水平明显升高。sdLDL-C在肾炎型患儿中升高更为明显,sdLDL-C、AT-Ⅲ联合检测对肾炎型PNS患儿具有一定的诊断价值,值得临床推广应用。

Objective To investigate the diagnostic value of low density lipoprotein cholesterol(sdLDL-C),cystatin C(Cys-C)and antithrombin-Ⅲ(AT-Ⅲ)in child primary nephrotic syndrome(PNS).Methods A total of 350 children patients with PNS admitted to the Pediatric Department of Suide County Hospital from January 2018 to June 2021 were collected as the observation group and divided into the simple type group(250 cases)and nephritis type group(100 cases)according to the clinical type.During the same period,100 healthy children were selected as the control group.The levels of sdLDL-C,Cys-C and AT-Ⅲ were compared among the all study subjects,and the diagnostic value of above indicators in children patients with nephritis type PNS was analyzed.Results The levels of sdLDL-C and Cys-C in the observation group were significantly higher than those in the control group,while the AT-Ⅲ level was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).The sdLDL-C level in the nephritis type group was significantly higher than that in the simple type group,the AT-Ⅲ level was significantly lower than that in the simple type group,and the differences were statistically significant(P<0.05).The area under the curve,sensitivity and specificity of sdLDL-C and AT-Ⅲ combined detection in diagnosing nephritis type PNS child were 0.881,90.0% and 78.8% respectively,which were significantly higher than those of single detection of sdLDL-C and AT-Ⅲ.Conclusion The levels of sdLDL-C,Cys-C are significantly increased in child with PNS.The increase of sdLDL-C is more significant in children patients with nephritis type.The sdLDL-C and AT-Ⅲ combined detection has certain diagnostic value for children patients with nephritis type PNS,which is worthy of clinical promotion and application.