过敏性紫癜患儿血清半胱氨酸蛋白酶抑制剂C和尿微量清蛋白检测的临床意义

Contents of serum Cyst-C and urinary microalbumin in children with Henoch-Schonlein purpura

摘要:

目的：探讨血清半胱氨酸蛋白酶抑制剂C(Cyst-C)和尿微量清蛋白(mA1b)在过敏性紫癜（HSP）患儿早期肾损害中的检测意义。方法：选取48例血清肌酐正常的HSP患儿作为观察组，31例健康儿童作为对照组。均抽血后采用碱性苦味酸法检测血清肌酐（Scr）、酶联免疫吸附方法（ELISA)测定血清Cyst-C、免疫比浊法检测尿mA1b，同时对观察组做尿常规检测。并且随诊患儿1个月后复查血Cyst-C和尿mA1b含量。结果：观察组患儿急性期血清Cyst-C为2.24±0.81 mg/L，高于对照组的0.85±0.20 mg/L，急性期尿mA1b为20.04±10.32 mg/L，高于对照组的2.30±1.38 mg/L。两者比较差异有非常显著性意义（P＜0.01)；HSP患儿急性期血清Cyst-C和尿mA1b与恢复期血清Cyst-C（1.70±0.30 mg/L）和尿mA1b（13.20±8.16 mg/L）比较，差异有非常显著性意义（P＜0.01)；HSP患儿的尿常规异常率为33.3%(16/48)，分别与尿mA1b异常率68.8%(32/48)、血清Cyst-C异常率72.9%(36/48)比较，差异有非常显著性意义（P＜0.01)；HSP患儿的尿mA1b与血Cyst-C异常率两者相接近，差异无显著性。结论：血清Cyst-C联合尿mA1b检测是诊断HSP早期肾损害的灵敏指标，可作为临床早期诊断的可靠依据。［中国当代儿科杂志，2009，11（5）：346-348］

Abstract:

OBJECTIVE: To investigate the clinical significance of serum Cyst-C and urinary microalbumin in early renal impairment in children with Henoch-Schonlein purpura (HSP). METHODS: Forty-eight children with HSP and who had normal serum creatinine level and 31 healthy children were enrolled. Contents of serum Cyst-C and urinary microalbumin were measured using ELISA and immunoturbidimetry, respectively. Urinary routine examination was performed in children with HSP. The contents of serum Cyst-C and urinary microalbumin were re-examined one month after treatment (recovery phase). RESULTS: The contents of serum Cyst-C (2.24±0.81 mg/L) and urinary microalbumin (20.04±10.32 mg/L) in the HSP group at the acute phase were significantly higher than those in the control (0.85±0.20 and 2.30±1.38 mg/L respectively; P<0.01). Serum Cyst-C (1.70±0.30 mg/L) and urinary microalbumin contents (13.20±8.16 mg/L) were significantly reduced at the recovery phase compared with those at the acute phase in the HSP group (P<0.01). The proportion of urinary routine abnormality (33.3%) was significantly lower than that of urinary microalbumin (68.8%) and serum Cyst-C abnormalities (72.9%) in the HSP group (P<0.01). CONCLUSIONS: Serum Cyst-C and urinary microalbumin may serve as indexes in the assessment of early renal impairment in children with HSP.［Chin J Contemp Pediatr, 2009, 11 (5):346-348］