血管紧张素原在儿童过敏性紫癜肾炎发生发展中的作用

发布时间：2018-08-29 16:19

【摘要】：目的过敏性紫癜(HSP)是儿童最常见的血管炎,约50%的HSP患儿累及肾脏,部分甚至进展为终末肾,然而其发病机制尚不明确;近年来研究发现肾内肾素-血管紧张素系统(RAS)可能参与紫癜性肾炎(HSPN)的发病。该研究拟探讨血管紧张素原(AGT)与儿童HSP肾损伤的相关性。方法选取30个HSPN患儿、31个HSP患儿及25个正常对照儿童。收集治疗前患儿及对照组的血液和新鲜晨尿,检测血清尿素氮(BUN)、肌酐(SCr)、肾小球滤过率(e GFR)、尿蛋白(UP)、尿肌酐(UCr)等指标,用人AGT ELISA试剂盒测定血清及尿液中的AGT含量。结果 HSPN组患儿尿血管紧张素原/尿肌酐(UAGT/UCr)水平高于HSP患儿及正常对照组儿童(P0.05);HSP患儿UAGT/UCr水平与正常对照组儿童两组间差异无统计学意义(P0.05)。3组血清AGT水平差异无统计学意义(P0.05)。UAGT与BUN和血清AGT无相关,与SCr和UP/UCr呈正相关,与e GFR呈负相关。结论肾内RAS活化可能参与HSP患儿肾脏损害的发生发展,可以通过监测UAGT来判断疾病的严重程度,预测过敏性紫癜肾损伤的进展及预后。
[Abstract]:Objective Henoch-Schonlein purpura (HSP) is the most common vasculitis in children. About 50% of the children with HSP involve the kidney, and some of them even progress to the terminal kidney. In recent years, it has been found that renal renin-angiotensin system (RAS) may be involved in the pathogenesis of purpura nephritis (HSPN). The aim of this study was to investigate the correlation between angiotensinogen (AGT) and renal injury in children with HSP. Methods 30 children with HSPN, 31 children with HSP and 25 normal children were selected. Serum urea nitrogen (BUN),) creatinine (BUN),) creatinine (SCr),) glomerular filtration rate (e GFR), urinary protein (UP), urinary creatinine (UCr), and AGT in serum and urine were measured by AGT ELISA kit. Results the levels of urinary angiotensinogen / urinary creatinine (UAGT/UCr) in HSPN group were higher than those in HSP group and normal control group (P0.05). There was no significant difference in serum AGT level between HSPN group and normal control group (P0.05). There was no correlation between UAGT and BUN and serum AGT. There was a positive correlation with SCr and UP/UCr, and a negative correlation with e GFR. Conclusion the activation of RAS in kidney may be involved in the development of renal damage in children with HSP. The severity of the disease can be judged by monitoring UAGT and the progression and prognosis of renal injury in Henoch-Schonlein purpura can be predicted.
【作者单位】：安徽医科大学第一附属医院儿科;
【基金】：安徽省自然科学基金项目(No:11040606M168)
【分类号】：R726.9

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