犀角地黄汤对小儿紫癜性肾炎肾功能及MCP-1、sVCAM-1的影响  

Effects of Xijiao Dihuang decoction on renal function and MCP-1,sVCAM-1 in children with Henoch-Schonlein purpura nephritis

作　　者：李美艳 陈琪 LI Meiyan;CHEN Qi(Department of Pediatrics,Changyuan Traditional Chinese Medicine Hospital,Changyuan 453400,China;Department of Nephrology,Luoyang Third People's Hospital,Luoyang 4710000,China)

机构地区：[1]长垣市中医医院儿科,长垣453400 [2]洛阳市第三人民医院肾病科,洛阳4710000

出　　处：《华夏医学》2025年第1期95-100,共6页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ202010118)。

摘　　要：目的观察犀角地黄汤对小儿紫癜性肾炎(HSPN)肾功能及单核细胞趋化蛋白-1(MCP-1)、可溶性血管细胞黏附分子-1(sVCAM-1)的影响。方法选取125例HSPN患儿,按照入院时肾功能损伤程度不同,分为轻度组45例和中重度组80例。所有患儿均采用犀角地黄汤辅助常规西医治疗,比较两组患儿治疗前后的肾功能指标以及MCP-1、sVCAM水平,检验血清MCP-1、sVCAM与HSPN患儿肾功能损伤情况的相关性,分析血清MCP-1、sVCAM对HSPN患儿肾功能损伤的预测价值。结果中重度组患儿的血清肌酐(SCr)、血尿酸(UA)、血尿素氮(BUN)、血清胱抑素C(CysC)、MCP-1、sVCAM与轻度组患儿比较,差异无统计学意义(P>0.05);血清MCP-1与SCr、UA、BUN、CysC正相关(P<0.05);血清sVCAM与SCr、UA、BUN、CysC正相关(P<0.05);血清MCP-1、sVCAM对HSPN患儿肾功能损伤的预测灵敏度、特异度较高(AUC=0.864、0.862)。结论犀角地黄汤辅助常规西药治疗,能够有效改善HSPN患儿的肾脏功能及MCP-1、sVCAM水平,动态监测MCP-1、sVCAM能够实现对肾功能损伤程度的早期评估。Objective To observe the effects of Xijiao Dihuang decoction on renal function,monocyte chemoattractant protein-1(MCP-1),and soluble vascular cell adhesion molecule-1(sVCAM-1)in children with Henoch-Schonlein purpura nephritis(HSPN).Methods 125 children with HSPN were selected and divided into a mild group(45 cases)and a moderate-to-severe group(80 cases)according to the degree of renal dysfunction at admission.All patients were treated with Xijiao Dihuang decoction as an adjunct to conventional Western medicine treatment.Renal function indicators,MCP-1,and sVCAM levels before and after treatment were compared between the two groups.The correlation between serum MCP-1,sVCAM,and renal function impairment in HSPN patients was examined,and the predictive value of serum MCP-1 and sVCAM for renal function impairment was analyzed.Results There was no statistically significant difference in serum creatinine(SCr),uric acid(UA),blood urea nitrogen(BUN),serum cystatin C(CysC),MCP-1,and sVCAM between the moderate-to-severe and mild groups,showing a statistically significant difference(P>0.05).Serum MCP-1 was positively correlated with SCr,UA,BUN,and CysC(P<0.05),and serum sVCAM was positively correlated with SCr,UA,BUN,and CysC(P<0.05).The sensitivity and specificity of serum MCP-1 and sVCAM for predicting renal function impairment in HSPN children were high(AUC=0.864,0.862).Conclusion Xijiao Dihuang decoction,when used in conjunction with conventional Western medicine,can effectively improve renal function in children with HSPN.MCP-1 and sVCAM levels are positively correlated with the degree of renal dysfunction,and dynamic monitoring of their levels can provide early prediction of renal function impairment.

关 键 词：小儿紫癜性肾炎 犀角地黄汤 肾功能损伤 单核细胞趋化蛋白-1 可溶性血管细胞黏附分子-1 

分 类 号：R726.9[医药卫生—儿科]