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目的观察尿单核细胞趋化蛋白(monocyte chemoattractant protein1,MCP-1)在不同尿白蛋白(albuminuria,ALB)水平紫癜性肾炎的变化,并探讨其意义。方法紫癜性肾炎患儿45例,按尿白蛋白测定分为A组:正常尿白蛋白患儿12例;B组:微量尿白蛋白患儿19例;C组:大量尿白蛋白患儿14例;过敏性紫癜无肾损害患儿12例作为D组;以上4组为观察组。对照组为健康儿童19例。分别测定患儿的尿MCP-1、尿β2-微球蛋白(β2-MG)及尿红细胞计数(RBC),并进行相关性分析。结果尿MCP-1水平在紫癜性肾炎患儿A~C组中均升高,明显高于对照组和D组(P<0.01),A、B、C组间两两比较差异有统计学意义(P<0.01);尿β2-MG水平在紫癜性肾炎患儿B、C组中升高,明显高于A、D和对照组(P<0.01),B、C2组间比较差异有统计学意义(P<0.01);尿红细胞计数A~C组明显高于对照组(P<0.01),A、B、C组间两两比较差异无统计学意义(P>0.05);紫癜性肾炎患儿A~C组尿MCP-1与尿β2-MG水平比较变化一致呈正相关(r=0.560,P=0.000),尿MCP-1、尿β2-MG水平与尿RBC计数比较无相关性(r=0.216、0.150,P=0.155、0.325)。结论尿MCP-1随紫癜性肾炎患儿不同尿白蛋白水平变化,有助于对紫癜性肾炎病情轻重作早期判断。
Objective To observe the changes of monocyte chemoattractant protein 1 (MCP-1) in purpura nephritis with different levels of albuminuria (ALB) and to explore its significance. Methods 45 cases of children with purpura nephritis were divided into group A according to urinary albumin determination: 12 cases of normal urinary albumin; Group B: 19 cases of microalbuminuria; Group C: 14 cases of large urine albumin Cases; Allergic Purpura without renal damage in 12 children as D group; more than 4 groups for the observation group. Control group of 19 healthy children. Urinary MCP-1, urinary β2-microglobulin (β2-MG) and urinary red blood cell count (RBC) were measured in children and their correlations were analyzed. Results The level of urinary MCP-1 in children with purpura nephritis was significantly higher than those in control group and D group (P <0.01), and there was significant difference between groups A, B and C (P <0.01). Urinary β2-MG levels in children with purpura nephritis increased in group B and C, which were significantly higher than those in group A and D (P <0.01). There was significant difference between group B and C2 (P <0.01). The urinary erythrocyte count in group A ~ C was significantly higher than that in control group (P <0.01), but there was no significant difference between group A, group B and group C (P> 0.05) There was a positive correlation between urinary MCP-1 and urinary β2-MG levels in children with A ~ C (r = 0.560, P = 0.000), urinary MCP-1 and urinary β2-MG levels = 0.216, 0.150, P = 0.155, 0.325). Conclusions Urinary MCP-1 varies with urinary albumin level in children with purpuric nephritis, which is helpful to make an early judgment on the severity of purpura nephritis.