上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (06): 841-846.doi: 10.3969/j.issn.1674-8115.2020.06.021

• 论著·临床研究 • 上一篇    下一篇

新型尿液标志物在紫癜性肾炎患儿中的水平变化

马一飞，李玉峰，郭桂梅，朱亚菊，龚莹靓，董 瑜   

  1. 上海交通大学医学院附属新华医院小儿肾脏内科，上海 200092
  • 出版日期:2020-06-28 发布日期:2020-06-28
  • 通讯作者: 李玉峰，电子信箱：liyufeng@xinhuamed.com.cn。
  • 作者简介:马一飞（1990—），男，回族，住院医师，硕士；电子信箱：727685219@qq.com。
  • 基金资助:
    上海市卫生和计划生育委员会科研课题(201640193)；上海交通大学医学院附属新华医院院级临床研究课题（15LC02，19XHCR17D）。

Changes of new urinary biomarkers in children with Henoch-Schonlein purpura nephritis

MA Yi-fei, LI Yu-feng, GUO Gui-mei, ZHU Ya-ju, GONG Ying-liang, DONG Yu   

  1. Department of Pediatric Nephrology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2020-06-28 Published:2020-06-28
  • Supported by:
    Project of Shanghai Municipal Health and Family Planning Commission (201640193)；Hospital Fund for Clinical Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine (15LC02, 19XHCR17D).

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摘要： 目的·研究尿血管紧张素原（urinary angiotensinogen，UAGT）、尿成纤维细胞特异蛋白-1（fibroblast-specific protein-1，FSP-1）及尿凝血酶在紫癜性肾炎（Henoch-Schonlein purpura nephritis，HSPN）患儿中的水平变化。方法·选取HSPN患儿（HSPN组，n=14）、过敏性紫癜（Henoch-Schonlein purpura，HSP）未合并肾脏受损患儿（HSP组，n=28）和尿检正常儿童（对照组，n=23）；同时选取不同治疗阶段的HSPN患儿，包括未治疗组（n=10）、完成糖皮质激素（glucocorticoid，GC）冲击治疗组（GC组，n=9）和完成GC联合环磷酰胺（cyclophosphamide，CTX）序贯冲击治疗组（GC+CTX组，n=8）。收集以上患儿的一般临床资料及新鲜晨尿标本，运用试剂盒检测尿中UAGT、FSP-1及凝血酶水平，并测定尿肌酐（urinary creatinine，Ucr）用于校正。结果·HSPN组患儿UAGT/Ucr及FSP-1水平显著高于HSP组及对照组（均P<0.05）；HSPN组患儿尿凝血酶水平与HSP组间差异无统计学意义，但2组水平均显著高于对照组（均P<0.05）。HSPN未治疗组患儿UAGT/Ucr水平与GC组间差异无统计学意义，但显著高于GC+CTX组（P=0.000）；未治疗组尿FSP-1水平显著高于GC组（P<0.05），但与GC+CTX组间差异无统计学意义；尿凝血酶水平在HSPN患儿的3个组间差异无统计学意义。结论·UAGT/Ucr、FSP-1和凝血酶水平在HSPN患儿尿液中均明显升高，且UAGT/Ucr和FSP-1可能对患儿的疗效有一定的提示作用。

关键词: 儿童, 紫癜性肾炎, 血管紧张素原, 成纤维细胞特异蛋白-1, 凝血酶, 尿液标志物

Abstract:

Objective · To evaluate the changes of urinary angiotensinogen (UAGT), fibroblast-specific protein-1 (FSP-1) and thrombin in the children with Henoch-Schonlein purpura nephritis (HSPN). Methods · Fourteen children with HSPN (HSPN group), 28 children with Henoch-Schonlein purpura (HSP) but without renal injury (HSP group) and 23 children with normal urinalysis (control group) were included in the study. Ten HSPN children before treatment (untreated group), 9 HSPN children after glucocorticoid (GC) pulse therapy (GC group) and 8 HSPN children after GC and cyclophosphamide (CTX) double pulse therapy (GC+CTX group) were also selected in the study. Clinical information and fresh morning urine samples were collected from all the children. UAGT, FSP-1 and thrombin in urine were measured by kits. Urine creatinine (Ucr) was also measured for correction. Results · UAGT/Ucr and FSP-1 in HSPN group were significantly higher than those in HSP group and control group (P<0.05). Thrombin in HSPN group had no significant difference, compared with HSP group (P>0.05), but thrombin levels in HSPN group and HSP group were both significantly higher than that in control group (P<0.05). UAGT/Ucr in HSPN untreated group had no significant difference, compared with GC group, while it was significantly higher than that in GC+CTX group (P=0.000). FSP-1 in untreated group was significantly higher than that in GC group, but had no significant difference, compared with GC+CTX group. There was no significant difference in thrombin among the 3 HSPN groups. Conclusion · UAGT/Ucr, FSP-1 and thrombin all increase in the urine of HSPN children, and UAGT/Ucr and FSP-1 may reflect the treatment effect to some extent.

Key words: children, Henoch-Schonlein purpura nephritis (HSPN), angiotensinogen (AGT), fibroblast-specific protein-1 (FSP-1), thrombin, urinary biomarker

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