中国实用儿科杂志

中国实用儿科杂志

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过敏性紫癜患儿血清高迁移率族蛋白B1表达及意义

  

  1. 重庆医科大学附属儿童医院风湿免疫科  儿童发育疾病研究教育部重点实验室  国家儿童健康与疾病临床医学研究中心（重庆）  儿童发育重大疾病国家国际科技合作基地  儿童感染免疫重庆市重点实验室，重庆  400014
  • 出版日期:2021-07-06 发布日期:2021-08-31

Expression and significance of serum high mobility group protein box 1 in Henoch-Schönlein purpura patients

  1. Department of Rheumatology and Immunology，Children’s Hospital of Chongqing Medical University；Ministry of Education Key Laboratory of Child Development and Disorders；National Clinical Research Center for Child Health and Disorders（Chongqing）；China International Science and Technology Cooperation Base of Child Development and Critical Disorders；Chongqing Key Laboratory of Child Infection and Immunity，Chongqing  400014，China
  • Online:2021-07-06 Published:2021-08-31

摘要： 目的　测定过敏性紫癜（HSP）患儿血清高迁移率族蛋白B1（HMGB1）水平， 分析血清HMGB1与实验室指标的相关性， 初步探讨HMGB1与HSP发病及肾损害的关系。方法　纳入2017年12月至2019年12月在重庆医科大学附属儿童医院初诊为HSP患儿83例， 其中45例无肾脏受累（A组）、 38例合并肾脏损害（B组）， 恢复期HSP患儿18例（C组）， 健康对照组20例（D组）， 采用酶联免疫吸附法测定患儿血清HMGB1水平。比较A组、 B组、 C组、 D组之间以及不同肾脏受累程度患儿血清HMGB1水平， 分析血清HMGB1与实验室指标的相关性。结果　（1）A组、B组、 C组、 D组患儿的血清HMGB1水平分别为： 10.71（6.81～16.03） μg/L、 13.77（10.02～22.72） μg/L、 7.58（5.73～10.83） μg/L、 4.96（3.97～5.43） μg/L， A组与B组、 C组、 D组之间的差异均有统计学意义（P＜0.05）。（2）急性期孤立性血尿型（12例）、 孤立性蛋白尿型（13例）、 血尿和蛋白尿型（13例）患儿血清HMGB1水平分别为： 10.98（8.07～16.38） μg/L、 12.81（8.45～20.89） μg/L、 17.39（13.02～27.79） μg/L， 3组之间的差异无统计学意义（P＞0.05）。（3）HSP患儿血清HMGB1水平与白细胞计数、 中性粒细胞百分比、 血清IgA浓度、 D-二聚体水平、 24 h尿蛋白定量之间呈线性正相关， 与淋巴细胞百分比呈线性负相关（P＜0.05）。结论　血清HMGB1表达与HSP肾脏损害有关， HMGB1可能参与HSP急性炎症。

关键词: 过敏性紫癜, 紫癜性肾炎, 高迁移率族蛋白B1, 儿童

Abstract: Objective　To investigate the serum level of high mobility group protein box 1（HMGB1） and its relationship with laboratory parameters in children with Henoch-Schönlein purpura（HSP），and to explore the role of HMGB1 in the pathogenesis of HSP and renal involvement. Methods　Eighty-three HSP patients newly diagnosed in Children’s Hospital of Chongqing Medical University from December 2017 to December 2019 were included. The patients without renal involvement were assigned as group A（45），and those with renal involvement were as group B（38）. Eighteen HSP patients in remission were included as group C and twenty healthy children as group D. Serum HMGB1 levels were measured by enzyme-linked immunosorbent assay and were compared among group A，B，and C，D and among children with different degrees of renal damage. The correlations between serum HMGB1 and laboratory parameters in HSP patients were analyzed. Results　The serum level of HMGB1 in group A，B，C and D was 10.71（6.81-16.03） μg/L，13.77（10.02-22.72） μg/L，7.58（5.73-10.83） μg/L，and 4.96（3.97-5.43） μg/L，respectively. The difference in serum HMGB1 levels between group A and B，group A and C，group A and D was statistically significant（P＜0.05）. Serum HMGB1 level in children with solitary hematuria（12 cases），solitary proteinuria（13 cases），hematuria and proteinuria（13 cases） was 10.98（8.07-16.38） μg/L，12.81（8.45-20.89） μg/L，17.39（13.02-27.79） μg/L，respectively；there was no significant difference in serum HMGB1 levels among the three groups（P＞0.05）. Serum HMGB1 levels was linearly positively correlated with white blood cell count，neutrophil percentage，serum IgA concentration，D-dimer and 24-hour urine protein quantification，and negatively correlated with the percentage of lymphocytes（P＜0.05）. Conclusion　The expression of serum HMGB1 is related to renal damage in HSP patients. HMGB1 may be involved in the acute inflammation of HSP.

Key words: Henoch-Schö, nlein purpura；Henoch-Schö, nlein purpura nephritis；high mobility group protein box 1；child