Abstract:

To evaluate the value of combined detection of serum cystatin C （Cys C） and urine protein series in predicting renal damage of childhood Henoch-Sch?nlein purpura （HSP）. Methods　Serum Cys C and urine protein series were tested in 46 child HSP patients，using liquid transmission turbidity and immune nephelometry. Urine protein series included transferrin （TRF），NAG /UCr，IGGU /UCr，ALBU /UCr and α1MU/UCr. Meanwhile，serum creatinine，urine and serum urea nitrogen were determined. The results were compared with those of healthy control group. Results　The value of serum Cys C and urine protein series in HSP patients were higher than those of control group （4.28±0.36） mg/L vs （0.65±0.43） mg/L for serum Cys C（P < 0.01）；80.43%（37/46） HSP patients whose routine urinalysis were negative had abnormal tested value of six indexes in complete blood test and urine analysis. The value of serum Cys C had a positive correlation with urine protein series. Conclusion　Six indexes in complete blood test and urine analysis including serum Cys C and urine protein series help to reveal early renal damage in HSP patients，whilst negative urinalysis can’t rule out early renal damage. The sensitivity and specificity of serum Cys C are superior to urine protein series. These six indexes are appropriate indicators in diagnosis of early renal injury in childhood HSP patients.

Key words: Henoch-Sch?nlein purpura, early renal damage, cystatin C, urine protein/creatinine ratio, children

摘要：

通过联合检测血清胱抑素C（Cys C）与尿微量蛋白系列，探讨其在儿童过敏性紫癜（HSP）早期肾脏损害诊断中的临床价值。方法　收集2009年7月至2011年1月在淮安市第二人民医院儿科住院的HSP患儿（早期尿常规阴性） 46例，采用液相透射比浊法及免疫散射比浊法测定患儿Cys C及尿微量蛋白系列［转铁蛋白（TRF）、N-乙酰-β-D-氨基葡萄糖苷酶/尿肌酐（NAG/UCr）、免疫球蛋白 （IGGU）/UCr、白蛋白 （ALBU）/UCr、α1-微球蛋白（α1MU）/UCr］，同时检测尿常规和血尿素氮（BUN）、血清肌酐（SCr），并与健康对照组进行比较。结果　HSP患儿Cys C、尿微量蛋白系列检测值明显高于健康对照组，差异有统计学意义（P均 < 0.01）；46例HSP患儿血、尿6项指标联合检测异常率为80.43%（37/46）；血清Cys C与尿微量蛋白系列呈正相关，该检测方法有助于发现早期尿常规阴性的紫癜性肾损害。结论　尿常规阴性并不能排除肾脏的早期损伤，血、尿6项指标联合检测是诊断HSP早期肾损伤的良好指标，且Cys C的灵敏度及特异度均优于尿微量蛋白，故血、尿6项指标联合检测可作为临床早期诊断肾损伤的可靠依据。

关键词: 胱抑素C, 尿微量蛋白/肌酐比值, 儿童, 过敏性紫癜, 早期肾损害