儿童紫癜性肾炎血清、尿液VCAM-1水平及临床意义

目的：探讨紫癜性肾炎（HSPN）患儿的血清、尿液可溶性血管细胞黏附分子-1（sVCAM-1）水平变化及临床意义。方法：过敏性紫癜（HSP）患儿50例，按有无肾脏累及分为HSPN组（30例）和HSP无肾受累（NO—HSPN）组（20例）；正常对照组20例。应用ELISA法检测各组血清、尿液sVCAM-1水平，进行比较，并分析其与主要临床指标（包括24h尿蛋白、尿红细胞）的关系。结果：HSPN组和NO-HSPN组的血清sVCAM-1水平分别为（809．79±173．32）ng／ml、（623．44±67．27）ng／ml]均高于对照组（494．79±59．84）ng／ml，P〈0．01，HSPN组的血清sVCAM-1水平高于NO—HSPN组（P〈0．01）。HSPN组的尿液sVCAM-1水平（121．24±110．83）ng／ml高于对照纽（20．61±16．76）ng／ml和NO—HSPN组（19．37±12．93）ng／ml，P均〈0．01，NO—HSPN组的尿液sVCAM-1水平与对照组比较，无统计学差异（P〉0．05）。HSPN患儿中，蛋白尿组高于无蛋白尿组（P均〈0．01），肾病蛋白尿组高于蛋白尿组（P均〈0．05）和无蛋白尿组（P均〈0．01）；肉眼血尿组的血清sVCAM-1水平高于无血尿组，与镜下血尿组比较无统计学差异（P〉0．05）；镜下血尿组的血清sVCAM-1浓度高于无血尿组（P〈0．01）；镜下血尿组和肉眼血尿组的尿液sVCAM-1水平明显高于无血尿组（P均〈0．05），镜下血尿组和肉眼血尿组之间无统计学差异（P〉0．05）。HSPN患儿的血清和尿液sVCAM-1水平均与24h尿蛋白量和尿红细胞量呈显著性正相关（P均〈0．01）。结论：VCAM-1可能参与了HSPN的发生、发展过程；尿液sVCAM-1的检测在监测肾脏损害方面具有较好的临床实用价值。

Concentration of VCAM-1 in Serum and Urine in Henoch-Schonlein Purpura Nephritis and its Clinical Significance

Objective:To explore the concentration of soluble vascular cellular adhesion molecule-1(sVCAM-1) in serum and urine in children with Henoch-Schonlein purpura nephritis(HSPN) and explore its clinical significance.Methods:There were 50 patients with HSP in the study.They were divided into two groups according to their renal lesions:30 cases with HSPN and 20 cases without HSPN(as NO-HSPN group).The control group included 20 healthy children.The concentration of sVCAM-1 in serum and urine of all children were d...