抗中性粒细胞胞浆抗体在小儿过敏性紫癜及其早期肾损害的临床意义

The clinical significance of ANCA in children with HSP and renal injury in children with HSP at early stage

目的 :了解抗中性粒细胞胞浆抗体 (ANCA)在小儿过敏性紫癜 (HSP)的阳性率 ,探讨ANCA与HSP早期肾损害的关系。方法 :对 48例HSP患儿在急性期用间接免疫荧光法 (IIF)和酶联免疫吸附试验 (ELISA)进行血清ANCA检测 ,将 48例分为ANCA阳性组及ANCA阴性组 ,同时检测患儿尿微量白蛋白 (Alb)及尿α1 微球蛋白 (α1 Mg) ,比较AN CA阳性组及ANCA阴性组的肾脏损害与ANCA的相关性。结果 :48例HSP患儿ANCA阳性 15例 ( 3 1 2 5 % ) ,其中核周型 (P ANCA) 9例 ,胞浆型 (C ANCA) 6例。ANCA阳性组肾损害明显高于ANCA阴性组 (P <0 0 1)。结论 :ANCA测定对HSP诊断有一定的临床价值 ,其活动性与HSP早期肾损害密切相关。

Objective To realize the positive rate of anti-neutrophil cytoplasmic antibodies (ANCA) in children with Henoch-Schonlein purpura(HSP),to investigate the relationship between ANCA and renal injury in children with HSP at early stage.Methods ANCA and their specific antigens in 48 children with HSP were detected by IIF and ELISA.48 children were devided into 2 groups:ANCA positive group and ANCA-negative group.Urinary micro albumin(Alb) and urinary α 1 microglobulin(α 1 Mg) were detected in all the children.The relationship between ANCA and renal injury in ANCA-positive group and ANCA-negative group.was compared.Results The results showed that percentage of ANCA-positive in 48 children with HSP was 15/48(31.25%).Among 15 ANCA-positive ones,9 cases were P-ANCA,and 6 cases were C-ANCA.As compared with ANCA-negative,the renal damages ratios had incrensed signnificantly in ANCA-positive group.Conclusion ANCA may be of chinical value in the diagnosis of children with HSP.There is a significant correlation between ANCA and renal injury in children with HSP at early stage.