尿单核细胞趋化蛋白-1水平在过敏性紫癜肾损害患儿中的意义  

Urine monocyte chemoattractant protein-1 in Henoch-Schonlein purpura children with nephritis

作　　者：沈梦娇[1] 戴霞华[2] 王佳佩 郑吉卡 狄亚珍[2] 钟世玲 应倩倩[1] 傅诗薇 

机构地区：[1]宁波大学医学院,浙江宁波315000 [2]宁波市妇女儿童医院小儿免疫风湿科,浙江宁波315000

出　　处：《临床荟萃》2017年第5期409-412,共4页Clinical Focus

基　　金：宁波市医学科技项目(2015C50014);浙江省医院卫生平台研究计划(2015ZDA027);宁波市自然基金项目(2014A610280)

摘　　要：目的探讨尿单核细胞趋化蛋白-1(MCP-1)水平在过敏性紫癜(HSP)肾损害患儿中的作用及意义。方法153例HSP患儿按是否合并紫癜性肾炎(HSPN)分成HSPN组(n=81)和HSP组(n=72);根据24小时蛋白定量(TUPr)将HSPN组患儿分为3组,轻度蛋白尿组(n=28)(TUPr<25mg/kg),中度蛋白尿组(n=32)(25mg/kg≤TUPr<50mg/kg)和重度蛋白尿组(n=21)(TUPr≥50mg/kg)。同时选取45例健康儿童为对照组,采用酶联免疫吸附测定方法检测各组尿液MCP-1水平。同时测定HSPN患儿血清尿素氮(BUN)和肌酐(Cr)、尿α1微球蛋白(α1-MG)、尿微量白蛋白(mAlb)、尿免疫球蛋白IgG(IgG)、尿转铁蛋白(TRF)、TUPr,分析尿MCP-1与上述指标的关系。结果 HSPN组尿MCP-1水平显著高于HSP组和健康对照组(P<0.05),HSP组与健康对照组尿MCP-1水平比较差异无统计学意义(P>0.05)。随着TUPr增加,HSPN各组尿液MCP-1表达水平呈明显递增趋势(P<0.05)。HSPN组尿MCP-1水平与尿α1-MG、mAlb、IgG、TRF及TUPr呈正相关,与血清BUN和Cr无关。结论紫癜性肾炎患儿尿MCP-1水平升高,且与尿蛋白相关,MCP-1作为炎性反应因子,可能参与了HSP肾损害的发生发展。Objective To investigate urinary monocyte chemoattractant protein-1（MCP-1）level and clinical significance in Henoch-Schonlein purpura（HSP）children with nephritis.Methods According to whether combined with Henoch-Schonlein purpura nephritis（HSPN）,153 HSP children were grouped into HSP group（n=72）and HSPN group（n=81）.According to total urine protein in 24hours（TUPr）,HSPN group was further divided into mild proteinuria group（n=28）（TUPr〈25mg/kg）,moderate proteinuria group（n=32）（25mg/kg≤TUPr〈50mg/kg）and severe proteinuria group（n=21）（TUPr≥50 mg/kg）.Meanwhile,45 healthy children were enrolled as control group.The level of urinary MCP-1 was measured by enzyme-linked immunosorbent assay.At the same time,the levels of serum creatinine,blood urea nitrogen（BUN）,urinary α1-micro globulin（α1-MG）,micro-albumin（mAlb）,immuno globulin G（IgG）,transferrin（TRF）and TUPr were detected for their associations with MCP-1.ResultsUrinary MCP-1was significantly higher in HSPN group in comparison with HSP group and control group（P〈0.05）,but no significant difference was found between HSP group and control group（P〉0.05）.With the increase of TUPr,urine MCP-1concentration in HSPN groups showed an obviously increasing trend.Urinary MCP-1correlated positively with urinaryα1-MG,mAlb,IgG,TRF and TUPr in HSPN,whereas it had no significant correlation with serum BUN and creatinine.Conclusion MCP-1increase in children with HSPN was correlated with proteinuria.And MCP-1played an important role in pathological process of HSP lesion.

关 键 词：紫癜 过敏性 肾小球肾炎 趋化因子CCL2 

分 类 号：R692.34[医药卫生—泌尿科学]