血清肿瘤坏死因子样凋亡弱诱导因子、血管生成抑制蛋白1在紫癜性肾炎患儿中表达水平及其诊断价值分析  

Analysis of the expression levels and diagnostic value of serum tumor necrosis factor-like weak inducer of apoptosis and vasohibin-1 in children with purpura nephritis

作　　者：侯晓锋[1] 陈斌 Hou Xiao-feng;Chen Bin(Department of Pediatrics,Laizhou City People's Hospital,Yantai 261400,China;Department of Emergency,Qingdao University Affiliated Women and Children's Hospital(Qingdao Women and Children's Hospital),Qingdao 266000,China)

机构地区：[1]莱州市人民医院儿科,烟台261400 [2]青岛大学附属妇女儿童医院(青岛市妇女儿童医院)急诊科,青岛266000

出　　处：《临床肾脏病杂志》2025年第2期130-135,共6页Journal Of Clinical Nephrology

摘　　要：目的检测紫癜性肾炎(henoch-schonlein purpura nephritis,HSPN)患儿血清肿瘤坏死因子样凋亡弱诱导因子(TNF-like weak inducer of apoptosis,TWEAK)、血管生成抑制蛋白1(vasohibin 1,VASH-1)水平,分析二者对HSPN的诊断价值。方法选取2018年8月至2022年8月106例莱州市人民医院已确诊收治的HSPN患儿为HSPN组、106例过敏性紫癜(henoch-schonlein purpura,HSP)患儿为HSP组,同期在本院体检的健康儿童106名为对照组,酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测血清中TWEAK、VASH-1水平;Pearson法分析HSPN患儿血清TWEAK与VASH-1表达相关性;绘制受试者工作特征(receiver operator characteristic curve,ROC)曲线分析TWEAK、VASH-1对HSPN的诊断价值;采用多因素Logistic回归分析影响HSPN的危险因素。结果HSPN组血清TWEAK、VASH-1水平分别为(61.82±17.94)ng/L、(342.19±54.37)ng/L,显著高于HSP组[TWEAK:(41.89±12.26)ng/L、VASH-1:(288.76±41.68)ng/L]和对照组[TWEAK:(35.94±10.18)ng/L、VASH-1:(275.46±35.81)ng/L],且HSP组高于对照组,组间比较差异具有统计学意义(均P<0.001);与TWEAK、VASH-1低表达组比较,TWEAK、VASH-1高表达组肾脏病理分级、24 h尿蛋白定量、胱抑素C(cystatin C,Cys C)、血肌酐(serum creatinine,Scr)、尿微量白蛋白(albumin,Alb)、血尿素氮(blood urea nitrogen,BUN)、尿免疫球蛋白A(immunoglobulin A,IgA)水平较高(P<0.05);HSPN患儿血清TWEAK与VASH-1表达水平呈显著正相关(r=0.657,P<0.001);TWEAK与VASH-1联合检测诊断HSPN的ROC曲线下面积为0.939(95%CI:0.898~0.967),敏感度为84.91%,特异度为88.68%;TWEAK(OR=1.528,95%CI:1.145~2.038)、VASH-1(OR=1.612,95%CI:1.081~2.404)、24 h尿蛋白定量(OR=1.652,95%CI:1.044~2.613)、Cys C(OR=1.498,95%CI:1.090~2.058)、Scr(OR=1.715,95%CI:1.061~2.772)、IgA(OR=1.395,95%CI:1.107~1.758)均是HSPN发生的危险因素(P<0.05)。结论TWEAK、VASH-1在HSPN患儿血清中高表达,两者与HSPN肾功能损伤指标密切相关,都是HSPN的危险因素,对HSPN存在�Objective To detect the serum levels of tumor necrosis factor-like weak inducer of apoptosis(TWEAK)and vasohibin-1(VASH-1)in children with Henoch-Schönlein purpura nephritis(HSPN),and to analyze their diagnostic value.Methods A total of 106 children with confirmed HSPN admitted to Laizhou City People's Hospital from August 2018 to August 2022 were regarded as the HSPN group,and 106 children with Henoch-Schönlein purpura(HSP)were regarded as the HSP group.During the same period,106 healthy children who underwent physical examination in our hospital were included in the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum TWEAK and VASH-1.Pearson method was applied to analyze the correlation between serum TWEAK and VASH-1 expressions in children with HSPN.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of TWEAK and VASH-1 for HSPN.Multivariate Logistic regression was applied to analyze the risk factors for HSPN.Results Serum TWEAK and VASH-1 levels in the HSPN group were 61.82±17.94 ng/L and 342.19±54.37 ng/L,respectively,which were significantly higher than those in the HSP group[TWEAK:(41.89±12.26)ng/L、VASH-1:(288.76±41.68)ng/L]and the control group[TWEAK:(35.94±10.18)ng/L、VASH-1:(275.46±35.81)ng/L].Serum TWEAK and VASH-1 were significantly higher in the HSP group than the control group(all P<0.001).Compared with the low expression groups of TWEAK and VASH-1,patients in the high expression groups of TWEAK and VASH-1 had significantly higher renal pathological grade,24 h urinary protein,Cystatin C(Cys C),serum creatinine(Scr),urinary albumin(Alb),blood urea nitrogen(BUN),and urinary immunoglobulin A(IgA)(P<0.05).Serum TWEAK was positively correlated with serum VASH-1 in children with HSPN(r=0.657,P<0.001).The area under the curve(AUC)of TWEAK combined withVASH-1 in the diagnosis of HSPN was 0.939(95%CI:0.898-0.967),with the sensitivity of 84.91%,and the specificity of 88.68%.TWEAK(OR=1.528,95%CI:1.145-2.038),VASH-1(OR=1.612,95%CI:1.08

关 键 词：紫癜性肾炎 肿瘤坏死因子样凋亡弱诱导因子 血管生成抑制蛋白1 诊断 

分 类 号：R726.9[医药卫生—儿科]