尿IgG联合尿蛋白定量对IgA血管炎肾炎患儿肾脏病理进展的预测价值  

The Value of Urinary IgG Combined with Urine Protein Quantification in Predicting Renal Pathological Progress in Children with IgA Vasculitis with Nephritis

作　　者：白梦刻 黄岩杰[1,2] 杨晓青[1,2] 梅晓峰[1,2] 李金刚[1,2] BAI Mengke;HUANG Yanjie;YANG Xiaoqing;MEI Xiaofeng;LI Jingang(Department of Pediatrics,the First Affiliated Hospital of He'nan University of Traditional Chinese Medicine,Zhengzhou 450000,China;College of Pediatrics,He'nan University of Traditional Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学第一附属医院儿科,郑州450000 [2]河南中医药大学儿科医学院,郑州450046

出　　处：《转化医学杂志》2023年第4期185-188,共4页Translational Medicine Journal

基　　金：2021年度国家自然科学基金面上项目(82174187);河南省中医药学科领军人才项目(豫卫中医函[2021]8号);河南省特色骨干学科中医学学科建设项目(STG-ZYXKY-2020008)。

摘　　要：目的探讨尿IgG/尿肌酐(UGCR)、24 h尿蛋白定量(24 h UP)、尿蛋白定量/尿肌酐(UPCR)在预测IgA血管炎肾炎(IgAVN)患儿肾脏病理进展中的价值。方法选取2018年1月—2022年10月收治的IgAVN患儿234例,均采集24 h尿液标本检测24 h UP。根据肾小球损伤程度不同将IgAVN患儿分为Ⅱ级47例、Ⅲ级175例、Ⅳ级12例,分析UGCR、24 h UP、UPCR与肾脏病理分级的相关性,通过受试者工作特征曲线分析上述指标预测肾脏IgAVN病理分级进展为Ⅲ级及以上的价值。结果肾脏病理分级Ⅲ级、Ⅳ级患儿UGCR、24 h UP、UPCR水平高于Ⅱ级患儿(P<0.01)。UGCR、24 h UP、UPCR与病理分级呈正相关,但相关性较弱(r=0.500、0.451、0.356,P<0.01)。UGCR、24 h UP和UPCR对IgAVN患儿肾脏病理分级进展为Ⅲ级及以上均具有预测价值,且三者联合检测预测价值更高(曲线下面积>0.9,P<0.01)。结论UGCR联合24 h UP、UPCR对IgAVN肾脏病理分级进展为Ⅲ级及以上的预测价值更高。Objective To investigate the value of urinary IgG/urinary creatinine(UGCR),24 h urinary protein(24 h UP),and urinary protein/urinary creatinine(UPCR)in the prediction of renal pathological progress in children with IgA vasculitis with nephritis(IgAVN).Methods A total of 234 children with IgAVN admitted from January 2018 to October 2022 were selected,and 24 h urine samples were collected for detection of 24 h UP.Children with IgAVN were divided into gradeⅡ(n=47),gradeⅢ(n=175)and gradeⅣ(n=12)according to the degree of glomerular injury.The correlation between UGCR,24 h UP,UPCR and pathological grading of the kidneys was analyzed.The value of the above indicators in predicting the progression of pathological grading of renal IgAVN to be gradeⅢor above was analyzed by receiver operating characteristic(ROC)curve.Results The levels of UGCR,24 h UP and UPCR in children with gradeⅢandⅣwere higher than those in children with gradeⅡ(P<0.01).UGCR,24 h UP and UPCR were positively and weekly correlated with pathological grades(r=0.500,0.451,0.356,P<0.01).UGCR,24 h UP and UPCR had the predictive value for the progression of renal pathological gradeⅢand above in children with IgAVN,and the combined detection of the three had the higher predictive value(area under the ROC curve>0.9,P<0.01).Conclusion UGCR combined with 24 h UP and UPCR has higher predictive value for renal pathological gradeⅢor above in children with IgAVN.

关 键 词：IgA血管炎肾炎 肾小球疾病 尿IgG/肌酐 24 h尿蛋白定量 尿蛋白/肌酐 肾脏病理分级 预测 儿童 

分 类 号：R725[医药卫生—儿科] R692.6[医药卫生—临床医学]