儿童过敏性紫癜肾炎KIM-1和IL-18水平及其与EB病毒感染的关系  

Levels of KIM-1 and IL-18 in children with Henoch-Schonlein purpura nephritis and their relationship with EB virus infection

作　　者：商亚敏 李英 戴颖 汪奇伟 SHANG Ya-min;LI Ying;DAI Ying;WANG Qi-wei(Huaihe Hospital,Henan University,Kaifeng,Henan 475000,China)

机构地区：[1]河南大学淮河医院儿科,河南开封475000

出　　处：《中华医院感染学杂志》2024年第4期594-598,共5页Chinese Journal of Nosocomiology

基　　金：河南省科技重点研发与推广专项基金资助项目(202102310094)。

摘　　要：目的 探究儿童过敏性紫癜肾炎(HSPN)肾损伤分子-1(KIM-1)、白细胞介素-18(IL-18)水平及其与EB病毒(EBV)的关系.方法 选取2019年1月—2022年12月河南大学淮河医院收治的238例过敏性紫癜(HSP)患儿为研究对象,根据HSPN情况分为HSPN组(n=96)和非HSPN组(n=142),比较两组肾功能指标[血肌酐(Scr)、尿素氮(BUN)、胱抑素C(Cys-C)、24 h尿蛋白定量]、免疫学指标[免疫球蛋白A(IgA)、补体3、补体4]、EBV拷贝数及尿液KIM-1、IL-18表达水平;根据HSPN患儿外周血EBV-DNA拷贝数,可分为EBV阳性组(n=37)和EBV阴性组(n=59),比较两组肾功能指标、免疫学指标及尿液KIM-1、IL-18水平;分析EBV DNA拷贝数及尿液KIM-1、IL-18与HSPN患儿肾小球病理分级关系.结果 HSPN组皮疹持续时间较非HSPN组长(P<0.05),Scr、BUN、Cys-C、24 h 尿蛋 白 定量、IgA、EBV DNA 拷贝数、KIM-1、IL-18 均较非 HSPN 组升高(P<0.05),补体3较非HSPN组下降(P<0.05);HSPN组EBV感染率为38.54%高于非HSPN组(P<0.05);EBV阳性组Cys-C、24 h尿蛋白定量、IgA、KIM-1、IL-18均高于EBV阴性组(P<0.05),补体3、补体4均低于阴性组(P<0.05);不同肾小球病理分级患儿EBV DNA拷贝数及尿液KIM-1、IL-18水平差异均有统计学意义(P<0.05),且均表现为Ⅳ级>Ⅲ级>Ⅱ级>Ⅰ级.结论 EBV感染与儿童HSPN发生和进展相关,可导致患儿尿液KIM-1、IL-18表达水平升高.OBJECTIVE To investigate the levels of kidney injury molecule-1(KIM-1)and interleukin-18(IL-18)in children with Henoch-Schonlein purpura nephritis(HSPN)and their relationship with Epstein-Barr virus(EBV).METHODS Totally 238 children with Henoch-Schonlein purpura(HSP)from Jan.2019 to Dec.2022 in Huaihe Hospital,Henan University were selected as the research subjects,and were divided into HSPN group(n=96)and non-HSPN group(n=142)according to the occurrence of HSPN.Renal function indicators[serum creatinine(Scr),blood urea nitrogen(BUN),cystatin C(Cys-C),24 h urinary protein quantification],immunological indi-cators[immunoglobulin A(IgA),complement 3,complement 4],EBV copy number and expression levels of KIM-1 and IL-18 in urine were compared between the two groups.Children with HSPN were divided into EBV-positive group(n=37)and EBV-negative group(n=59)according to the EBV DNA copy number in peripheral blood,and the renal function indicators,immunological indicators and urine KIM-1 and IL-18 levels were com-pared between both groups.The relationship between EBV DNA copy number,urine KIM-1 and IL-18 levels and glomerular pathological grading in children with HSPN was analyzed.RESULTS The duration of rash in HSPN group was longer than that in non-HSPN group(P<0.05),and Scr,BUN,Cys-C,24 h urinary protein quantifi-cation,IgA,EBV DNA copy number,KIM-1 and IL-18 were increased than those in non-HSPN group(P<0.05),while complement 3 was decreased than that in non-HSPN group(P<0.05).The infection rate of EBV in HSPN group was 38.54%,which was higher than 24.82%in non-HSPN group(P<0.05).The Cys-C,24 h u-rinary protein quantification,IgA,KIM-1 and IL-18 in EBV-positive group were higher than those in EBV-nega-tive group(P<0.05),while complement 3 and complement 4 were lower than those in EBV-negative group(P<0.05).There were statistically significant differences in EBV DNA copy number,and urine KIM-1 and IL-18 lev-els among children with different glomerular pathological grades(P<0.05),and the results were shown as gradeⅣ>g

关 键 词：过敏性紫癜肾炎 儿童 EB病毒 肾损伤分子-1 白细胞介素-18 

分 类 号：R554.6[医药卫生—血液循环系统疾病]