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目的:探讨可溶性血管细胞黏附分子(sVCAM-1)与血管内皮生长因子(VEGF)在儿童紫癜性肾炎(HSPN)的变化及临床意义。方法:采用酶联免疫吸附法(ELASA)检测HSPN组59例,过敏性紫癜组55例,并选取HSPN患儿处于急性期35例,恢复期41例及68例健康对照儿童血清sVCAM-1、VEGF水平。结果:儿童紫癜性肾炎组血清sVCAM-1、VEGF水平较正常对照组均明显升高(P<0.001)。肾炎组血清sVCAM-1水平较单纯过敏性紫癜组明显升高(P<0.01),肾炎组较单纯过敏性紫癜组血清VEGF水平升高,但差异无显著意义(P>0.05)。儿童HSPN急性组血清sVCAM-1、VEGF水平明显高于恢复期和正常对照组(P<0.001)。恢复期组与正常对照组比较,sVCAM-1水平差异无统计学意义(P>0.05),而VEGF水平差异有显著性意义(P<0.01)。HSPN急性期血清sVCAM-1水平与VEGF水平呈显著正相关(P<0.01)。结论:sVCAM-1、VEGF参与了儿童紫癜性肾炎的发病过程,且反映其病情进展变化程度。
Objective: To investigate the changes and clinical significance of soluble vascular cell adhesion molecule (sVCAM-1) and vascular endothelial growth factor (VEGF) in children with purpura nephritis (HSPN). Methods: 59 cases of HSPN group and 55 cases of allergic purpura were detected by enzyme-linked immunosorbent assay (ELASA). 35 cases of HSPN in acute stage, 41 cases of convalescent stage and 68 healthy children were enrolled in this study. Serum sVCAM- VEGF levels. Results: Serum levels of sVCAM-1 and VEGF in children with purpura nephritis were significantly higher than those in normal controls (P <0.001). Serum levels of sVCAM-1 in nephritis group were significantly higher than those in simple allergic purpura group (P <0.01). Serum VEGF level in nephritis group was higher than that in simple allergic purpura group, but the difference was not significant (P> 0.05). Serum levels of sVCAM-1 and VEGF in children with acute HSPN were significantly higher than those in recovery and normal controls (P <0.001). There was no significant difference in sVCAM-1 levels between the recovery group and the normal control group (P> 0.05), while the VEGF level was significantly different (P <0.01). Serum levels of sVCAM-1 in acute stage of HSPN were positively correlated with VEGF levels (P <0.01). Conclusion: sVCAM-1 and VEGF are involved in the pathogenesis of purpura nephritis in children and reflect the degree of their progression.