血清Cystain C、尿NGAL及尿损份分子1联合检测对儿童过敏性紫癜早期肾损伤的诊断效能

发布时间：2019-03-10 18:50

【摘要】：目的观察血清半胱氨酸蛋白酶抑制剂C(Cystatin C)和尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、尿肾损伤分子-1(KIM-1)联合检测对儿童过敏性紫癜(HSP)早期肾损伤(HSPN)的诊断效能。方法选择36例HSPN患儿为HSPN组,36例无肾炎的HSP患儿为HSP组,22例健康儿童为对照组。采用胶乳增强免疫比浊法检测各组患儿血清Cystatin C,采用ELISA法检测各组患儿尿NGAL、KIM-1,采用化学发光法检测各组患儿尿肌酐(u Cr)。比较各组血清Cystatin C、尿NGAL/u Cr、KIM-1/u Cr。绘制血清Cystatin C、尿NGAL/u Cr、KIM-1/u Cr及三者联合检测诊断HSPN的受试者工作曲线(ROC曲线),计算曲线下面积、截断值及灵敏度、特异度。结果HSPN、HSP组患儿血清Cystatin C均高于对照组(P均0.05),但是HSPN组患儿血清Cystatin C与HSP组相比P0.05。HSPN组患儿尿NGAL/u Cr、KIM-1/u Cr均高于HSP组和对照组(P均0.05),但是HSP组患儿尿NGAL/u Cr、KIM-1/u Cr与对照组相比P均0.05。血清Cystatin C、尿NGAL/u Cr、尿KIM-1/u Cr诊断HSPN的ROC曲线的曲线下面积(AUC)分别为0.679(95%CI:0.543~0.815,P=0.023)、0.716(95%CI:0.586~0.846,P=0.006)和0.681(95%CI:0.539~0.822,P=0.022)。选取的截断点分别为0.575 mg/L、2.695×10-2ng/mg和0.615×10-2ng/mg,相应的敏感度分别为58.3%、61.1%和66.7%,特异度分别为68.2%、77.3%和72.7%。三者联合检测诊断HSPN的AUC为0.814,敏感性、特异性分别为88.9%、63.6%。结论血清Cystatin C、尿NGAL、尿KIM-1联合检测诊断HSPN的效能优于单独检测。
[Abstract]:Objective to observe the serum cysteine protease inhibitor C (Cystatin C) and urinary neutrophil gelatinase-associated lipid delivery protein (NGAL),). Combined detection of urinary renal injury molecule-1 (KIM-1) in children with Henoch-Schonlein purpura (HSP) in the early stage of renal injury (HSPN) diagnostic efficacy. Methods 36 cases of HSPN, 36 cases of HSP without glomerulonephritis and 22 cases of healthy children were selected as HSPN group, HSP group and control group. Serum Cystatin C was detected by latex enhanced immunoturbidimetry, urine NGAL,KIM-1, was detected by ELISA and creatinine (u Cr). Was detected by chemiluminescent method. Serum Cystatin C and urine NGAL/u Cr,KIM-1/u Cr. were compared in each group. The receiver operating curve (ROC curve) of serum Cystatin C, urine NGAL/u Cr,KIM-1/u Cr and their combined detection for diagnosis of HSPN was drawn. The area under the curve, cut-off value, sensitivity and specificity were calculated. Results the serum level of Cystatin C in HSPN,HSP group was higher than that in control group (P0.05), but the serum Cystatin C in HSPN group was higher than that in HSP group. The urine NGAL/u Cr, in P0.05.HSPN group was higher than that in P0.05.HSPN group. KIM-1/u Cr was higher than that in HSP group and control group (P0.05), but urinary NGAL/u Cr,KIM-1/u Cr in HSP group was significantly higher than that in control group (P0.05). The area (AUC) under the curve of serum Cystatin C and urine NGAL/u Cr, urine KIM-1/u Cr for diagnosis of HSPN was 0.679 (95% CI 0.543 渭 0.815, P < 0.023) and 0.716 (95% CI 0.586 渭 0.846, P < 0.05), respectively. P0. 006) and 0.681 (95% CI 0. 539, 0. 822, P = 0. 022). The cut-off points were 0.575 mg/L, 2.695 脳 10-2ng/mg and 0.615 脳 10-2 ng / mg, respectively. The corresponding sensitivity was 58.3%, 61.1% and 66.7%, respectively. The specificity was 68.2%, 77.3% and 72.7%, respectively. The AUC of HSPN was 0.814, the sensitivity and specificity were 88.9% and 63.6%, respectively. Conclusion the combined detection of serum Cystatin-C and urinary NGAL,-urinary KIM-1 is superior to that of single detection in the diagnosis of HSPN.
【作者单位】：徐州医学院附属连云港医院;
【基金】：连云港市科技局社会发展计划项目(QN121001)
【分类号】：R725.5;R726.9

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