ESM-1和sICAM-1在儿童过敏性紫癜和紫癜性肾炎中的变化及意义
发布时间：2018-12-20 22:20
【摘要】：目的研究内皮细胞特异性分子-1(ESM-1/Endocan)及可溶性细胞间粘附分子-1(s ICAM-1)在过敏性紫癜(HSP)和紫癜性肾炎(HSPN)血清中的含量,及ESM-1在肾脏组织中的表达情况,寻找可反映HSP肾脏受累的新指标并提供理论依据。方法选取2015年10月至2016年8月于郑州大学第一附属医院儿内科住院治疗的74例患儿为实验组,其中HSP组32例,HSPN组42例;门诊健康体检儿童21例为对照组。HSPN组又分为肾穿组30例(RB患儿),保守治疗者12例;RB患儿进一步分为A组:Ⅱ及以下,8例;B组:Ⅲa,14例;C组:Ⅲb,8例;另选取8例微小病变(MCD)患儿的肾穿组织作为肾组织的正常对照组。应用ELISA法检测研究对象血清ESM-1、s ICAM-1水平,免疫组织化学染色法检测ESM-1在肾脏组织中的表达。应用SPSS 21.0对结果进行数据分析。结果1、三组血清ESM-1、s ICAM-1水平HSP组及HSPN组血清ESM-1、s ICAM-1水平明显高于对照组,且HSPN组高于HSP组,差异均有统计学意义(均P0.01)。HSPN组大量蛋白尿与非大量蛋白尿之间血s ICAM-1差异具有统计学意义(Z=-2.575,P=0.01),而血ESM-1差异无统计学意义(t=-1.01,P=0.318)。RB患儿各病理组别之间的血ESM-1、s ICAM-1水平差异无统计学意义(χ2=0.298,P=0.585;χ2=1.892,P=0.401)。2、肾小球中ESM-1的表达(AOD值)MCD组、A组、B组及C组肾小球ESM-1表达水平(AOD值)总体分布不同,差异具有统计学意义(F=10.09,P0.01)。进一步两两比较发现,C组AOD值均高于其他各组,且与MCD组、A组、B组之间的差异均有显著性统计学意义(均P0.01),而MCD组、A组、B组相互之间AOD值差异未见统计学意义(均P0.05)。3、ESM-1与病理级别的相关性RB患儿肾脏ESM-1与病理级别呈正相关(r=0.617,P0.01);并与血清ESM-1水平成正相关(r=0.783,P0.01);而RB患儿血清ESM-1水平与其肾脏病理级别无相关性(r=0.169,P=0.371)。4、ESM-1、s ICAM-1与各临床指标相关性分析血清ESM-1与血s ICAM-1与成正相关(r=0.894,P0.01);血ESM-1、s ICAM-1与D-二聚体均呈负相关(r=-0.320,P=0.013;r=-0.291,P=0.024);血ESM-1、s ICAM-1与尿NAG酶均呈正相关(r=0.324,P=0.015;r=0.275,P=0.041)。结论1、ESM-1和s ICAM-1可能均参与了HSP及HSPN的发生和发展。2、ESM-1和s ICAM-1可以作为HSP累及肾脏的客观指标。3、监测血ESM-1的水平可以间接反映肾脏组织ESM-1的表达情况。
[Abstract]:Objective to study the contents of endothelial cell-specific molecule-1 (ESM-1/Endocan) and soluble intercellular adhesion molecule-1 (s ICAM-1) in serum of Henoch-Schonlein purpura (HSP) and Henoch-Schonlein purpura nephritis (HSPN). And the expression of ESM-1 in renal tissue to find a new index which can reflect the renal involvement of HSP and provide theoretical basis. Methods from October 2015 to August 2016, 74 children who were hospitalized in Department of Pediatrics, first affiliated Hospital of Zhengzhou University were selected as experimental group, including 32 cases in HSP group and 42 cases in HSPN group. HSPN group was divided into renal puncture group (30 cases) and conservative treatment group (12 cases). Children with RB were further divided into group A (8 cases), group B (14 cases) and group C (8 cases). The renal perforating tissues of 8 patients with minimal change (MCD) were selected as the normal control group. The level of serum ESM-1,s ICAM-1 was detected by ELISA and the expression of ESM-1 in renal tissue was detected by immunohistochemical staining. The results were analyzed by SPSS 21. 0. Results 1. The serum ESM-1,s ICAM-1 levels in the three groups were significantly higher in the HSP group and HSPN group than in the control group, and the serum ESM-1,s ICAM-1 level in the HSPN group was higher than that in the HSP group. There was significant difference in blood s ICAM-1 between large albuminuria and non large proteinuria in P0.01). HSPN group (P 0.01). However, there was no significant difference in serum ESM-1 level between different pathological groups (蠂 ~ 2 = 0.298P, P < 0.585). There was no significant difference in blood ESM-1,s ICAM-1 level between different pathological groups (t = -1.01g / min, P = 0.318). The expression of ESM-1 (AOD value) in glomeruli of MCD group, A group, B group and C group were different in total distribution (AOD value), and the difference was statistically significant (F0. 09% P0.01). Further comparison showed that the AOD value of group C was higher than that of other groups, and there was significant difference between group C and group MCD, group A and group B (P0.01), while in group MCD, group A, there was a significant difference between them (P0.01). There was no significant difference in AOD between the two groups (P0.05). 3 the correlation between ESM-1 and pathological grade was positive correlation between renal ESM-1 and pathological grade in RB children (r = 0.617, P0.01). There was a positive correlation between serum ESM-1 level and serum ESM-1 level (r = 0.783, P0.01). However, there was no correlation between serum ESM-1 level and renal pathological grade in children with RB (r = 0.169). The correlation between serum ESM-1 and serum s ICAM-1 was positive (r = 0.894, r = 0.894). P0.01); There was a negative correlation between serum ESM-1,s ICAM-1 and D-dimer (r = 0.320), a positive correlation between serum ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.324), and a positive correlation between serum ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.324, P = 0.015), and a positive correlation between blood ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.320, P = 0.013, P = 0.291, P = 0.024). R = 0.275, P = 0.041). Conclusion 1 both ESM-1 and s ICAM-1 may be involved in the occurrence and development of HSP and HSPN. 2ESM-1 and s ICAM-1 can be used as objective indexes of renal involvement of HSP. Monitoring the level of blood ESM-1 can indirectly reflect the expression of ESM-1 in renal tissue.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.5;R726.9
本文编号：2388503
[Abstract]:Objective to study the contents of endothelial cell-specific molecule-1 (ESM-1/Endocan) and soluble intercellular adhesion molecule-1 (s ICAM-1) in serum of Henoch-Schonlein purpura (HSP) and Henoch-Schonlein purpura nephritis (HSPN). And the expression of ESM-1 in renal tissue to find a new index which can reflect the renal involvement of HSP and provide theoretical basis. Methods from October 2015 to August 2016, 74 children who were hospitalized in Department of Pediatrics, first affiliated Hospital of Zhengzhou University were selected as experimental group, including 32 cases in HSP group and 42 cases in HSPN group. HSPN group was divided into renal puncture group (30 cases) and conservative treatment group (12 cases). Children with RB were further divided into group A (8 cases), group B (14 cases) and group C (8 cases). The renal perforating tissues of 8 patients with minimal change (MCD) were selected as the normal control group. The level of serum ESM-1,s ICAM-1 was detected by ELISA and the expression of ESM-1 in renal tissue was detected by immunohistochemical staining. The results were analyzed by SPSS 21. 0. Results 1. The serum ESM-1,s ICAM-1 levels in the three groups were significantly higher in the HSP group and HSPN group than in the control group, and the serum ESM-1,s ICAM-1 level in the HSPN group was higher than that in the HSP group. There was significant difference in blood s ICAM-1 between large albuminuria and non large proteinuria in P0.01). HSPN group (P 0.01). However, there was no significant difference in serum ESM-1 level between different pathological groups (蠂 ~ 2 = 0.298P, P < 0.585). There was no significant difference in blood ESM-1,s ICAM-1 level between different pathological groups (t = -1.01g / min, P = 0.318). The expression of ESM-1 (AOD value) in glomeruli of MCD group, A group, B group and C group were different in total distribution (AOD value), and the difference was statistically significant (F0. 09% P0.01). Further comparison showed that the AOD value of group C was higher than that of other groups, and there was significant difference between group C and group MCD, group A and group B (P0.01), while in group MCD, group A, there was a significant difference between them (P0.01). There was no significant difference in AOD between the two groups (P0.05). 3 the correlation between ESM-1 and pathological grade was positive correlation between renal ESM-1 and pathological grade in RB children (r = 0.617, P0.01). There was a positive correlation between serum ESM-1 level and serum ESM-1 level (r = 0.783, P0.01). However, there was no correlation between serum ESM-1 level and renal pathological grade in children with RB (r = 0.169). The correlation between serum ESM-1 and serum s ICAM-1 was positive (r = 0.894, r = 0.894). P0.01); There was a negative correlation between serum ESM-1,s ICAM-1 and D-dimer (r = 0.320), a positive correlation between serum ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.324), and a positive correlation between serum ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.324, P = 0.015), and a positive correlation between blood ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.320, P = 0.013, P = 0.291, P = 0.024). R = 0.275, P = 0.041). Conclusion 1 both ESM-1 and s ICAM-1 may be involved in the occurrence and development of HSP and HSPN. 2ESM-1 and s ICAM-1 can be used as objective indexes of renal involvement of HSP. Monitoring the level of blood ESM-1 can indirectly reflect the expression of ESM-1 in renal tissue.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.5;R726.9
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