龙 莉,刘 艳,徐小评.紫癜性肾炎患儿血清白细胞介素类异常表达与其肾脏病理分级、肾损伤的关联性研究[J].转化医学杂志,2022,11(5):282-286
紫癜性肾炎患儿血清白细胞介素类异常表达与其肾脏病理分级、肾损伤的关联性研究
Relationship between abnormal expression of serum interleukin and renal pathological grade and renal injury in children with Henoch Schonlein purpura nephritis
  
DOI:
中文关键词:  紫癜性肾炎  血清白细胞介素  肾脏病理分级  肾损伤
英文关键词:Purpura nephritis  Serum interleukin  Pathological grade of kidney  Kidney injury
基金项目:
作者单位
龙 莉 成都市第二人民医院儿科 
刘 艳 成都市第二人民医院儿科 
徐小评 成都市第二人民医院儿科 
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中文摘要:
      目的 探讨紫癜性肾炎(henoch-Sch?nlein purpura nephritis, HSPN)患儿血清白细胞介素类异常表达与其肾脏病理分级、肾损伤的关联性。方法 选取2019年1月-2022年1月成都市第二人民医院收治的120例初次诊断为HSPN患儿作为研究组,另收集本院同期健康体检儿童50例为对照组,采用ELISA法测定两组血清中的IL-18、IL-17和IL-33,紫癜性肾炎患儿血清白细胞介素类异常表达与其肾脏病理分级、肾损伤的关联性采用Pearson相关性分析。结果 研究组IL-18、IL-17和IL-33表达水平均高于对照组(P<0.05)。根据HSPN肾脏病理分级标准,将所有患者分为I、II、IIa、IIb、IV、V级,分别为2、29、38、45、3、3例,各级患者的IL-18、IL-17和IL-33表达水平比较均存在统计学差异(P<0.05),且随着肾脏病理分级越高,IL-18、IL-17和IL-33表达水平也越高。进一步相关性分析结果显示,IL-18、IL-17和IL-33与肾脏病理分级均存在相关性(P<0.05)。各级患者的尿微量白蛋白、尿转铁蛋白、尿β微球蛋白、尿素氮、肌酐表达水平比较均存在统计学差异(P<0.05),且随着肾脏病理分级越高,上述肾损伤指标表达水平也越高。进一步相关性分析结果显示,IL-18和IL-33均与尿β微球蛋白存在相关性(P<0.05),这提示紫癜性肾炎患儿血清白细胞介素类异常表达与肾损伤的存在一定的相关性;多因素logistic回归分析显示,IL-18、IL-17、IL-33、肾脏病理分级是肾脏损伤的独立影响因素[OR(95% CI):3.010(1.510~6.001),2.796(1.525~5.129),3.229(1.604~6.499),3.108(1.574~6.136),P<0.05]。结论 紫癜性肾炎患儿血清白细胞介素类(IL-17、IL-8、IL-33)异常表达与其肾脏病理分级、肾损伤均存在关联性,临床可根据白细胞介素类的表达水平进行相关诊治。
英文摘要:
      Objective To investigate the relationship between the abnormal expression of serum interleukin and renal pathological grade and renal injury in children with Henoch Schonlein purpura nephritis. Methods A total of 120 children who were initially diagnosed as HSPN from January 2019 to January 2022 were enrolled as study group, and 50 healthy children were collected as control group during the same period in the Second People's Hospital of Chengdu. The serum levels of IL-18, IL-17, and IL-33 of two groups were measured by enzyme-linked immuno sorbent assay (ELISA). The correlation between the abnormal expression of serum interleukin in children with purpura nephritis and their renal pathological grade and renal injury was analyzed by Pearson correlation. Results The expression levels of IL-18, IL-17, and IL-33 in the study group were higher than these in the control group (P<0.05). According to the renal pathological grading standard of HSPN, all patients were divided into grade I, II, IIA, IIB, IV, and V with 2, 29, 38, 45, 3, and 3 cases respectively. There were differences in the expression levels of IL-18, IL-17, and IL-33 between different grade (P<0.05), and the higher renal pathological grading was, the higher the expression levels of IL-18, IL-17, and IL-33 were. Further correlation analysis showed that IL-18, IL-17, and IL-33 were correlated with renal pathological grade (P<0.05). The urinary microalbumin, urinary transferrin, urine β microglobulin, urea nitrogen, and creatinine were differently expressed in different groups (P<0.05). The higher pathological grade of kidney, the higher expression levels of the above renal injury indicators. Further correlation analysis showed that IL-18 and IL-33 were correlated with urine β microglobulin, which suggestted that the abnormal expression of serum interleukin in children with Henoch Schonlein purpura nephritis was related to renal injury. Multivariate logistic regression analysis showed that IL-18, IL-17, IL-33, and renal pathological grade were independent influencing factors of renal injury (OR (95%CI): 3.010 (1.510~6.001), 2.796 (1.525~5.129), 3.229 (1.604~6.499), 3.108 (1.574~6.136), P<0.05). Conclusion The abnormal expression of serum interleukins (IL-17, IL-8, IL-33) in children with Henoch Schonlein purpura nephritis is related to the pathological grade of kidneys and renal injury. Clinical diagnosis and treatment can be carried out according to the expression level of interleukin.
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