激素敏感型原发性肾病综合征患儿血清ANGPTL8、新蝶呤水平及临床意义  

Levels and clinical significance of serum ANGPTL8 and neopterin in childrenwith hormone sensitive primary nephrotic syndrome

作　　者：周天珍 胡茂娟 彭海琳 熊伟 ZHOU Tianzhen;HU Maojuan;PENG Hailin;XIONG Wei(Department of Pediatrics,West China Second University Hospital,Sichuan University·Qingbaijiang Women′s and Children′s Hospital,Chengdu,Sichuan 610300,China)

机构地区：[1]四川大学华西第二医院·青白江区妇女儿童医院儿科,四川成都610300

出　　处：《国际检验医学杂志》2024年第10期1165-1170,共6页International Journal of Laboratory Medicine

基　　金：四川省医学会(青年创新)科研课题(Q20029)。

摘　　要：目的 探究激素敏感型原发性肾病综合征(NS)患儿血清血管生成素样蛋白8(ANGPTL8)、新蝶呤水平及临床意义。方法 选取2018年1月至2021年1月该院诊治的159例激素敏感型原发性NS患儿为研究对象(NS组)。随访1年,根据是否发生频复发,分为非频复发亚组(n=93)和频复发亚组(n=66),另选取该院儿外科择期手术的60例腹股沟斜疝患儿为对照组。酶联免疫吸附试验(ELISA)检测血清ANGPTL8、新蝶呤水平。比较各组血清ANGPTL8、新蝶呤水平。多因素Logistic回归分析影响激素敏感型原发性NS患儿频复发的危险因素。受试者工作特征(ROC)曲线分析血清ANGPTL8、新蝶呤对激素敏感型原发性NS患儿频复发的预测价值。结果 NS组血清ANGPTL8、新蝶呤水平明显高于对照组,差异有统计学意义(t=20.948、44.288,P<0.001、0.001)。频复发亚组血清ANGPTL8、新蝶呤水平、CD8^(+)T细胞、24 h尿蛋白定量及尿蛋白转阴时间明显高于非频复发亚组,而血白蛋白、CD4^(+)T细胞、CD4^(+)/CD8^(+)T细胞比值低于非频复发亚组,差异有统计学意义(均P<0.05)。NS患儿血清ANGPTL8、新蝶呤水平与24 h尿蛋白量、CD8^(+)T细胞呈显著正相关,与血白蛋白、CD4^(+)T细胞、CD4^(+)/CD8^(+)呈显著负相关(均P<0.05)。血清ANGPTL8、新蝶呤水平是影响激素敏感型原发性NS患儿频复发的独立危险因素(P<0.05)。血清ANGPTL8、新蝶呤联合模型对激素敏感型原发性NS患儿频复发预测的曲线下面积(AUC)为0.852(95%CI:0.813~0.889),高于ANGPTL8、新蝶呤单一指标检测的0.764(95%CI:0.722~0.812),0.749(95%CI:0.711~0.790),差异具有统计学意义(Z=3.623、3.987,P=0.003、<0.001)。结论 血清ANGPTL8、新蝶呤水平升高是影响激素敏感型原发性NS患儿频复发的危险因素。血清ANGPTL8、新蝶呤联合检测对激素敏感型原发性NS患儿频复发具有较高的预测价值。Objective To study the levels and clinical significance of serum angiopoietin-like protein 8(ANGPTL8)and neopurine in children with hormone sensitive primary nephrotic syndrome(NS).Methods A total of 159 children with hormone sensitive primary NS treated in the hospital from January 2018 to January 2021 were selected as the study subjects(NS group).After 1 year of follow-up,based on whether frequent recurrence occurred,they were divided into the non frequent recurrence subgroup(n=93)and the frequent recurrence subgroup(n=66).Additionally,60 children with oblique hernia who underwent elective surgery in the Department of Pediatrics in the hospital were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of ANGPTL8 and neopterin.The serum levels of ANGPTL8 and neopterin in each group were compared.Multivariate Logistic regression analysis was used to analyze risk factors for frequent recurrence in children with hormone sensitive primary NS.The predictive value of serum ANGPTL8 and neopterin in predicting frequent recurrence in children with hormone sensitive primary NS was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of ANGPTL8 and neopterin in the NS group were higher than those in the control group,and the differences were statistically significant(t=20.948,44.288,P<0.001,0.001).The serum ANGPTL8,neopterin levels,CD8^(+)T cells,24 h urine protein quantification,and urine protein conversion time in the frequent recurrence subgroup were significantly higher than those in the non frequent recurrence subgroup,while the blood albumin,CD4^(+)T cells,CD4^(+)/CD8^(+)T cell ratios were lower than those in the non frequent recurrence subgroup,and the differences were statistically significant(all P<0.05).The serum levels of ANGPTL8 and neopterin in NS patients were significantly positively correlated with 24 h urine protein and CD8^(+)T cells,while they were significantly negatively correlated with serum albumin,CD4^(+)T cells,CD4^(+)/CD8

关 键 词：肾病综合征 儿童 血管生成素样蛋白8 新蝶呤 频复发 

分 类 号：R726.9[医药卫生—儿科]