血栓调节蛋白、血管性假血友病因子、基质金属蛋白酶-9在过敏性紫癜肾损害早期诊断中的价值  

Clinical Value of Thrombomodulin,Von Willebrand Factor,Matrix Metalloproteinase-9 in Earlier Diagnosis of Henoch-Schonlein Purpura Nephritis in Children

作　　者：蔡维艳[1] 李爱敏[1] 初清[1] 周广玉[1] 柳雪梅[1] 李春香[1] 柳宏波 

机构地区：[1]烟台毓璜顶医院儿科,山东烟台264000

出　　处：《实用儿科临床杂志》2012年第17期1340-1342,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨过敏性紫癜(HSP)患儿血浆血栓调节蛋白(TM)、血管性假血友病因子(vWF)、基质金属蛋白酶-9(MMP-9)在HSP肾损害早期诊断中的价值。方法应用ELISA法检测60例健康儿童(健康对照组)及160例HSP患儿急性期血浆TM、vWF、MMP-9水平。随访6个月～1 a,发生肾损害62例,非肾损害98例,按肾损害临床表现分为A组:孤立性血尿(18例)或孤立性蛋白尿(3例);B组:血尿+蛋白尿(29例);C组:大量蛋白尿(12例)。比较肾损害组、非肾损害组及健康对照组中各数值变化及在肾损害不同组中的差异。结果 1.肾损害组TM[(148.13±18.60)mg.L-1]、vWF[(159.50±23.06)%]、MMP-9[(36.53±7.86)mg.L-1]均高于非肾损害组[(129.49±21.22)mg.L-1、(136.98±25.48)%、(29.14±8.17)mg.L-1]及健康对照组[(113.63±20.88)mg.L-1、(121.83±24.69)%、(24.37±7.34)mg.L-1],差异均有统计学意义(Pa<0.05);非肾损害组与健康对照组比较差异均无统计学意义(Pa>0.05)。2.肾损害组:C组、B组TM[(158.59±17.80)mg.L-1、(149.72±19.20)mg.L-1]、vWF[(169.45±23.36)%、(160.20±21.46)%]、MMP-9[(42.66±6.31)mg.L-1、(35.88±7.33)mg.L-1]高于A组[(131.28±16.14)mg.L-1、(139.59±19.26)%、(30.16±6.89)mg.L-1],差异均有统计学意义(Pa<0.05);C组MMP-9水平高于B组,差异有统计学意义(P<0.05),而TM、vWF在2组之间差异均无统计学意义(Pa>0.05)。结论 TM、vWF、MMP-9在HSP急性期升高,可作为早期预测肾损害的指标,联合检测有利于早期预测肾损害的发生及肾损害的程度。Objective To explore the value of thrombomodulin（TM）,von Willebrand factor（vWF）,and matrix metalloproteinase-9（MMP-9） in the early diagnosis of Henoch-Schonlein purpura（HSP）nephritis by detecting the plasma levels of the 3 factors in children with HSP. Methods The plasma levels of TM,vWF,MMP-9 were measured by enzyme-linked immunosorbent assay（ELISA） in 160 children with acute HSP and 60 healthy children（healthy control group）,and they were followed up for 6 months to 1 year.In HSP group,62 cases of HSP nephropathy and 98 cases of HSP non-nephropathy patients were enrolled in the study.The patients with HSP nephropathy were divided into 3 subgroups according to different clinical features：subgroup A included single blood urine（n=18） or albuminuria（n=3）,subgroup B included blood urine and albuminuria（n=29）,and subgroup C included albuminuria（n=12）.The levels of the 3 indexes in HSP nephropathy group,HSP non-nephropathy group and healthy control group were compared,respectively.Furthermore,the differences of 3 indexes in subgroup A,B and C of HSP nephropathy group were analyzed. Results 1.The plasma levels of TM[（148.13±18.60） mg·L-1],vWF[（159.50±23.06）%],MMP-9[（36.53±7.86） mg·L-1] were significantly higher in HSP nephropathy group than those in the non-HSP nephropathy group[（129.49±21.22） mg·L-1,（136.98±25.48）%,（29.14±8.17） mg·L-1] and those in control group[（113.63±20.88） mg·L-1,（121.83±24.69）%,（24.37±7.34） mg·L-1],respectively（Pa〈0.05）.There was no significant difference in plasma levels of them between non-HSP nephropathy group and healthy control group（Pa〉0.05）.2.In HSP nephropathy group,the plasma levels of TM,vWF,MMP-9 in subgroup C and subgroup B[TM：（158.59±17.80） mg·L-1,（149.72±19.20） mg·L-1;vWF：（169.45±23.36）%,（160.20±21.46）%;MMP-9：（42.66±6.31） mg·L-1,（35.88±7.33） mg·L-1] were significantly higher than those in subgroup A[（131.28±16.14） mg·L-1、（139.59±

关 键 词：紫癜性肾炎 血栓调节蛋白 血管性假血友病因子 基质金属蛋白酶-9 

分 类 号：R725.5[医药卫生—儿科]