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中华妇幼临床医学杂志(电子版) ›› 2016, Vol. 12 ›› Issue (05) : 521 -524. doi: 10.3877/cma.j.issn.1673-5250.2016.05.006

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论著

肾损伤分子-1对儿童紫癜性肾炎伴急性肾损伤早期诊断的意义
于生友1,(), 任琪2, 于力1   
  1. 1. 510180 广州市第一人民医院儿科
    2. 510180 广州市妇女儿童医疗中心过敏风湿免疫科
  • 收稿日期:2016-05-15 修回日期:2016-08-15 出版日期:2016-10-01
  • 通信作者: 于生友

Clinical significance of kidney injury molecule-1 for early diagnosis of children with purpura nephritis and acute kidney injury

Shengyou Yu1,(), Qi Ren2, Li Yu1   

  1. 1. Department of Pediatrics, Guangzhou First People′s Hospital, Guangzhou 510180, Guangdong Province, China
    2. Department of Pediatric Allergy Immunology, Guangzhou Women and Children′s Medical Center, Guangzhou 510180, Guangdong Province, China
  • Received:2016-05-15 Revised:2016-08-15 Published:2016-10-01
  • Corresponding author: Shengyou Yu
  • About author:
    Corresponding author:Yu Shengyou,Email:
引用本文:

于生友, 任琪, 于力. 肾损伤分子-1对儿童紫癜性肾炎伴急性肾损伤早期诊断的意义[J/OL]. 中华妇幼临床医学杂志(电子版), 2016, 12(05): 521-524.

Shengyou Yu, Qi Ren, Li Yu. Clinical significance of kidney injury molecule-1 for early diagnosis of children with purpura nephritis and acute kidney injury[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2016, 12(05): 521-524.

目的

探讨肾损伤分子(KIM)-1对儿童紫癜性肾炎(HSPN)伴急性肾损伤(AKI)早期诊断的临床意义。

方法

选择2010年1月至2016年1月,在广州市第一人民医院儿童肾脏科住院的100例HSPN(肾病综合征型)患儿为研究对象。按照是否存在AKI,将受试者分为HSPN伴AKI组和HSPN组,每组各50例。留取两组患儿的血、尿标本进行血肌酐、24 h尿蛋白定量等相关实验室检查,并采用酶联免疫吸附测定(ELISA)法检测患儿血清、尿KIM-1含量;对两组各10例自愿行肾脏穿刺活检术患儿的肾脏标本,采用免疫组化法检测KIM-1在患儿肾脏的表达及部位。两组患儿年龄和体重比较,差异无统计学意义(P>0.05)。所有受试者的监护人均签署自愿参加实验的知情同意书,并通过病例收集医院伦理委员会的伦理评审。

结果

①HSPN伴AKI组患儿血清肌酐、胱抑素(Cys)C,以及血清和尿β2-微球蛋白(MG)与KIM-1水平,均显著高于HSPN组患儿,而血红蛋白(Hb)、血清白蛋白及肾小球滤过率(GFR),则显著低于HSPN组患儿,且差异均有统计学意义(P<0.05)。两组患儿24 h尿蛋白定量比较,差异无统计学意义(P>0.05)。②肾脏穿刺组织行免疫组化染色显示,HSPN组未见明显棕黄色颗粒表达,染色浅;而HSPN伴AKI组棕黄色颗粒多,染色深,主要表达在肾小管上皮细胞。

结论

血清、尿KIM-1含量检测,有助于早期诊断儿童HSPN伴AKI。

Objective

To evaluate the clinical significance of kidney injury molecules (KIM)-1 in early diagnosis of children with Henoch-Schonlein purpura nephritis(HSPN) and acute kidney injury(AKI).

Methods

A total of 100 cases of HSPN children (nephrotic syndrome type) in Guangzhou First People′s Hospital from January 2010 to January 2016, who were chosen as study objects. According to suffered by AKI or not, they were divided into HSPN with AKI group and HSPN group, 50 cases in each group. Blood and urine samples were collected of two groups of children for related laboratory tests, such as serum and urine creatinine, 24 h urine protein quantitative etc., using enzyme-linked immunosorbent assay(ELISA) method to detect the contents of serum and urine KIM-1. For the 10 cases of voluntary kidney biopsy children in each group, their kidney specimens were using immunohistochemical method to detect KIM-1 expression and distribution in the children′s kidney tissue. There were no significant differences between two groups of children in age and weight(P>0.05). All the subjects′ parents signed the informed consents of volunteered for the experiment, and was approved by the Ethical Review Board of Investigation in Human Being of Guangzhou First People′s Hospital.

Results

①The levels of serum creatinine, serum cystatin(Cys) C, serum and urine β2-microglobulin(MG), and serum and urine KIM-1 of children in HSPN with AKI group were higher than those of HSPN group, but, the hemoglobin(Hb), serum albumin and glomerular filtration rate(GFR) were lower than those of HSPN group, and the differences were statistically significant(P<0.05). There was no significant difference between two groups in 24 h urine protein quantitative(P>0.05). ② The immunohistochemical staining of renal biopsy showed that there was no obvious tan particles expression in HSPN group, and staining shallow; However, tan particles were more, deep dyeing, and mainly expressed in renal tubular epithelial cells in HSPN with AKI group.

Conclusions

The serum and urine KIM-1 content detection is helpful for the early diagnosis of HSPN children with AKI.

表1 两组患儿各临床指标比较(±s)
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