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目的:探讨中性粒细胞明胶酶相关脂质运载蛋白、胱抑素C和免疫球蛋白水平检测在儿童过敏性紫癜(HSP)早期肾损害诊断中的应用价值及相关性。方法:将60患儿分为HSP普通型组30例、HSP肾型组30例,另随机选择同期门诊体检儿童60例为对照组,检测受试者血浆NGAL、尿胱抑素和免疫球蛋白(IgA、IgM、IgG)的水平。结果:3组患儿NGAL、胱抑素C和IgA水平比较,差异有统计学意义(P<0.05);3组IgM、IgG之间比较,差异无统计学意义(P>0.05)。HSP肾型组较NGAL、胱抑素C和IgA含量高于对照组,差异有统计学意义(X2=22.4,28.3,19.7,P<0.05);HSP肾型组NGAL、胱抑素C和IgA含量高于HSP普通型组,差异有统计学意义(X2=25.7,32.6,22.1,P<0.05)。NGAL与胱抑素C呈正相关(r=12.36,P<0.05);NGAL与IgA呈正相关(r=17.01,P<0.05);胱抑素C与IgA呈正相关(r=22.25,P<0.05)。结论:NGAL、胱抑素和免疫球蛋白水平对于HSP的诊断具有一定的价值,尤其对患儿肾功能早期损害的诊断,早期联合检测三者的水平,适时地给予预防性治疗,对保护HSP患儿的脏器功能、改善预后具有重要的临床意义。
Objective: To investigate the value and correlation of detection of neutrophil gelatinase-associated lipocalin, cystatin C and immunoglobulin levels in the diagnosis of early renal damage in children with Henoch-Schonlein purpura (HSP). Methods: Sixty children were divided into 30 cases of HSP common type and 30 cases of HSP nephropathy group. Another 60 children were randomly selected as the control group. Plasma NGAL, urine cystatin and immunoglobulin (IgA, IgM, IgG) levels. Results: The levels of NGAL, Cystatin C and IgA in the three groups were significantly different (P <0.05). There was no significant difference between the three groups in IgM and IgG (P> 0.05). The levels of NGAL, cystatin C and IgA in HSP group were significantly higher than those in NGAL group (χ2 = 22.4,28.3,19.7, P <0.05) The content was higher than HSP common type group, the difference was statistically significant (X2 = 25.7,32.6,22.1, P <0.05). There was a positive correlation between NGAL and cystatin C (r = 12.36, P <0.05). There was a positive correlation between NGAL and IgA (r = 17.01, P <0.05) . Conclusions: The levels of NGAL, cystatin and immunoglobulin have some value for the diagnosis of HSP. Especially for the diagnosis of early renal damage in children and the early detection of combined three levels of prophylaxis, prophylactic treatment of HSP Children’s organ function, improve prognosis has important clinical significance.