【摘要】 目的探讨过敏性紫癜及紫癜性肾炎患儿胰岛素样生长因子-1(IGF-1)变化的临床意义。方法选择过敏性紫癜(HSP组)患儿31例和紫癜性肾炎(HSPN组)患儿28例及健康对照儿童(正常对照组)31例,分别采集血清,用酶联免疫吸附测定法(ELISA)法测定各组血清标本的IGF-1浓度,HSPN组检测24h尿蛋白定量。结果 (1)正常对照组、HSP组、HSPN组血清IGF-1水平分别为(0.272 2±0.107 1)、(0.599 9±0.346 8)、(0.906 0±0.346 8)ng/L,3组间比较差异有统计学意义(F=22.98,P<0.05),HSPN组血清IGF-1水平高于HSP组和正常对照组(P均<0.05)。(2)在12例进行肾穿刺活检的HSPN患儿中,血清IGF-1表达水平最高可达1.376ng/L,最低为0.198ng/L,随着HSPN的病理分级加重,血清IGF-1水平有增高趋势。(3)有蛋白尿的HSPN患儿的血清IGF-1水平高于无蛋白尿的HSPN患儿(P<0.05),有血尿和无血尿的HSP患儿血清中IGF-1水平差异无统计学意义(P>0.05)。(4)HSPN组患儿随尿蛋白水平的增加,血清IGF-1表达水平逐渐增加(P<0.05)。结论在HSP急性发作期可以观测到增加的IGF-1,其水平的提高可能与蛋白尿的水平有关,并可作为预测早期肾小球和肾小管损害的指标。IGF-1水平可能是一个肾脏受累的指标。更多还原

【Abstract】 Objective To investigate the clinical significance of detecting IGF-1 level in children with Henoch-schoenlein purpura(HSP) or Henoch-schoenlein purpura nephritis(HSPN).Methods Ninty children in total with HSP or HSPN and normal children were recruited.And they were divided into three groups:the HSP group with 31 cases,the HSPN group with 28 cases,and the control group with 31 cases.The serum level of insulin and insulin-like growth factor-1(IGF-1) was tested by enzyme linked immunosorbent assay(ELISA) respectively.At the same time,total urine protein level in 24 hours was determined in 28 HSPN children.Results(1) The serum level of IGF-1 in the control group was(0.272 2±0.107 1) ng/L,while that in the HSP group was(0.599 9±0.346 8)ng/L,and that in the HSPN group was(0.906 0±0.346 8)ng/L.There existed significant difference among the three groups(F=22.98,P<0.05),and serum level of IGF-1 in the HSPN group was higher than that in the HSP group and the control group(P<0.05).(2) Among 12 cases of children who underwent renal puncture biopsy,the highest serum level of IGF-1 was 1.376 ng/L,while the lowest level was 0.187 ng/L,and serum IGF-1 level has a tendency of becoming higher with the severity of histopathological changes.(3) Serum IGF-1 level of the HSPN children with proteinuria is higher than that of the HSPN children without proteinuria(P<0.05).There was no significant difference between the serum IGF-1 level of the HSP children with and without hematuria(P>0.05).(4) The serum IGF-1 level increases with the protein level in the uria becoming higher among HSPN group(P<0.05).Conclusion Increasing serum level of IGF-1 was observed in the acute onset period of HSP,also this increasing level could be related to the degree of proteinuria,it thus can be an index for predicting early stage of glomerulus and nephric tubule injury.Therefore,serum level of IGF-1 may be indicative of a renal involvement in HSP.更多还原