中国实用儿科杂志

中国实用儿科杂志 ›› 2011, Vol. 26 ›› Issue (06): 443-.

• 论著 • 上一篇    下一篇

胱抑素C联合尿微量蛋白和肌酐检测诊断儿童过敏性紫癜早期肾损害临床价值研究

  

  1. 江苏省淮安市第二人民医院  a. 儿科，b. 肾脏病实验室，江苏淮安　223002
  • 收稿日期:2011-03-01 修回日期:2011-03-02 出版日期:2011-06-05 发布日期:2011-07-05

The value of cystatin C and urine protein/creatinine ratio detection in predicting early renal damage of children with Henoch-Sch?nlein purpura.

  1. Department of Pediatrics，The Second People’s Hospital of Huai’an ，Huai’an 223002，China
  • Received:2011-03-01 Revised:2011-03-02 Online:2011-06-05 Published:2011-07-05

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

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