尿液蛋白标志物在儿童HSP早期肾损伤诊断中的意义  

Clinical significance of urine biomarkers for early renal damage of children with Henoch-Schonlein purpura

作　　者：吕志勇[1] 宋文琪[1] 

机构地区：[1]首都医科大学附属北京儿童医院检验中心,北京100045

出　　处：《中国妇幼健康研究》2018年第1期18-21,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨尿液蛋白标志物检测在儿童过敏性紫癜(HSP)和紫癜性肾炎(HSPN)诊断中的应用价值,从而准确判断儿童HSP有无肾脏早期损伤。方法选择2016年4至6月在北京儿童医院住院或体检的儿童共166例,其中包括58例普通型HSP患儿、58例HSPN患儿和50例正常健康儿童。分别检测并比较各组儿童尿液中IgG、微量白蛋白(mAlb)、转铁蛋白(TRU)、α1-微球蛋白(A1M)和N-乙酰-β-D-氨基-葡萄糖苷酶(NAG)的水平,血液中尿素(UREA)和肌酐(Cr)的水平。结果 HSPN组患儿尿液中IgG、mAlb、TRU、A1M、NAG水平均高于HSP组和健康对照组(Z=-8.724^-5.757,均P<0.05);HSPN组患儿尿液中IgG、mAlb、TRU、A1M、NAG阳性率均高于HSP组(χ2=19.414~82.818,均P<0.05);HSPN组患儿尿液中IgG、mAlb、TRU、A1M、NAG五项指标中两项联合检测的阳性率明显高于单独检测的阳性率(χ2=4.997~48.758,均P<0.05)。结论尿液中IgG、mAlb、TRU、A1M、NAG水平可作为诊断HSP儿童早期肾损伤的临床检测指标,通过多项目联合检测可明显提高HSP早期肾损伤诊断灵敏度。Objectives To investigate the diagnostic value of urine biomarkers in early renal damage of children with HenochSchonlein purpura（HSP）and henoch-schonlein purpura nephritis（HSPN）.Methods From April to June in 2016 totally 166 children were selected,including 58 cases of HSP ordinary type,58 cases of HSPN and 50 cases of normal controls.The levels of IgG,microalbumin（mAlb）,transferrin（TRU）,αl-Microglobulin（A1 M）,N-acety-β-D-glucosaminidase（NAG）in urine,and the levels of urea nitrogen（UREA）and creatinine（Cr）in blood were detected and compared.Results The levels of urine IgG,mAlb,TRU,A1 M,and NAG of HSPN group were significantly higher than those of HSP group or control group（Z value ranged-8.724--5.757,all P0.05）.The positive rates of urine IgG,mAlb,TRU,A1 M,and NAG of HSPN group were significantly higher than HSP group（χ2 value ranged 19.4140-82.818,all P0.05）.The positive rate of the combined detection of either two of these five urine biomarkers was significantly higher than single index detection（χ2 value ranged 4.997-48.758,all P0.05）.Conclusion The levels of urine IgG,mAlb,TRU,A1 Mand NAG can be used as clinical detection indices in diagnosis of early renal damage of children with HSP.Furthermore,combined detection of these urine biomarkers can significantly enhance the diagnostic sensitivity.

关 键 词：过敏性紫癜 紫癜性肾炎 肾损伤 儿童 

分 类 号：R725.5[医药卫生—儿科]