小儿原发性肾病综合征患者血浆蛋白Z、凝血因子Ⅷ活性变化及临床意义

Changes and Clinical Significance of Plasma Protein Z and Coagulation FactorⅧActivities in Children with Primary Nephrotic Syndrome

目的探讨小儿原发性肾病综合征患者血浆蛋白Z、凝血因子Ⅷ活性变化及临床意义。方法同时选取2019年10月至2021年9月河南科技大学第一附属医院收治的原发性肾病综合征患儿和在本院进行健康体检儿童,各75例,分别纳入试验组和参照组。采集空腹血,利用酶联免疫吸附试验测定血浆蛋白Z水平和凝血因子Ⅷ活性;观察两组指标在小儿原发性肾病综合征患者中的变化和临床意义。结果试验组血浆蛋白Z(0.45±0.11)pg/mL低于参照组(1.41±0.22)pg/mL,凝血因子Ⅷ活性(149.52±16.22)ng/mL高于参照组(127.85±15.64)ng/mL,差异有统计学意义(t=33.801、8.329,均P<0.05)。纳入急性发作期患儿33例,纳入恢复期患儿42例,经检测急性发作期患儿血浆蛋白Z水平(0.33±0.02)pg/mL低于恢复期患儿(1.12±0.19)pg/mL,凝血因子Ⅷ活性(168.52±15.97)ng/mL高于恢复期患儿(135.74±14.65)ng/mL,差异有统计学意义(t=23.748、9.245,均P<0.05)。经Pearson相关性检验显示,血浆蛋白Z和凝血因子Ⅷ之间呈负相关性,差异有统计学意义(r=-0.619,P=0.002)。结论与健康体检儿童相比,原发性肾病综合征患儿血浆蛋白Z水平呈明显低水平表达状态,凝血因子Ⅷ呈明显高水平表达状态,且急性发作期患儿血浆蛋白Z的低水平表达和凝血因子Ⅷ高水平表达情况较恢复期患儿相比更加明显,两项指标之间呈负相关性,对小儿原发性肾病综合征发生及发展的预测具有一定的临床价值。

Objective To investigate the changes and clinical significance of plasma protein Z and coagulation factorⅧin children with primary nephrotic syndrome.Methods Children with primary nephrotic syndrome admitted to the First Affiliated Hospital of Henan University of Science and Technology from October 2019 to September 2021 and children who underwent health check-ups in our hospital,75 cases each,were selected and included in the test and reference groups,respectively.Fasting blood was collected and plasma protein Z level and coagulation factorⅧactivity were measured using enzymelinked immunosorbent assay;the changes and clinical significance of the indicators in pediatric patients with primary nephrotic syndrome in both groups were observed.Results Plasma protein Z(0.45±0.11)pg/mL in the test group was lower than that in the reference group(1.41±0.22)pg/mL,and coagulation factorⅧactivity(149.52±16.22)ng/mL was higher than that in the reference group(127.85±15.64)ng/mL,and the differences were statistically significant(t=33.801,8.329,both P<0.05).Thirty-three children were included in the acute exacerbation period and 42 children were included in the recovery period,and the plasma protein Z level(0.33±0.02)pg/mL was tested to be lower in the acute exacerbation period than in the recovery period(1.12±0.19)pg/mL,and the coagulation factorⅧactivity(168.52±15.97)ng/mL was higher than in the recovery period(135.74±14.65)ng/mL,with statistically significant differences(t=23.748,9.245,both P<0.05).The Pearson correlation test showed a negative correlation between plasma protein Z and coagulation factorⅧ,with a statistically significant difference(r=-0.619,P=0.002).Conclusion Compared with healthy children,children with primary nephrotic syndrome showed significantly lower expression of plasma protein Z and higher expression of coagulation factorⅧand the low expression of plasma protein Z and high expression of coagulation factorⅧwere more pronounced in children with acute exacerbation than in children with recovery,and there was a negative correlation between the two indicators,which is of clinical value in predicting the occurrence and development of primary nephrotic syndrome in children.