肾脏剪切波速与BMP-7、CTGF在小儿原发性肾病综合征诊治中的应用研究
发布时间：2018-11-11 18:22
【摘要】：目的本研究应用声触诊组织定量分析(VTQ)技术检测原发性肾病综合征(PNS)患儿及健康儿童肾实质的剪切波速(SWV),同时测定所有患儿血清骨形态发生蛋白-7(BMP-7)及结缔组织生长因子(CTGF)水平,比较各组间的血清BMP-7、CTGF水平及肾实质SWV,并将肾实质SWV与血清BMP-7、CTGF水平进行相关性分析,探讨血清BMP-7、CTGF与肾实质SWV在小儿PNS肾间质纤维化诊治中的应用价值。方法将150例PNS患儿根据肾穿刺病理结果,按照肾间质损害程度分为轻、中、重度间质纤维化三组,另选择50例健康儿童作为对照组,用酶联免疫吸附实验(ELISA)方法检测各组血清BMP-7、CTGF水平,并利用VTQ技术检测各组肾实质SWV,比较各组间的血清BMP-7、CTGF水平及肾实质SWV,然后将PNS组的血清BMP-7、CTGF水平与SWV进行相关性分析。结果对照组、小儿PNS组在年龄、性别、体质量指数方面差异均无统计学意义(P0.05);对照组与小儿PNS组BUN、CRE无统计学差异,24h Ualb、血浆总蛋白、血浆胆固醇差异显著(P0.05);血清BMP-7水平:轻度组中度组重度组,血清CTGF水平:轻度组中度组重度组,肾实质SWV测值:轻度组中度组重度组;轻度肾间质纤维化组与对照组比较血清BMP-7、CTGF水平及肾实质SWV差异均无统计学意义,中、重度间质纤维化组与对照组比较差异均有统计学意义(P0.05);小儿PNS不同肾间质纤维化分期组间两两比较,血清BMP-7、CTGF水平及肾实质SWV差异也均有统计学意义(P0.05);血清BMP-7水平与CTGF水平呈显著负相关(r=-0.798、-0.672,P0.05),血清BMP-7水平与肾实质SWV呈显著负相关(r=-0.672,P0.05),血清CTGF水平与肾实质SWV呈显著正相关(r=0.702,P0.05)。结论PNS患儿肾实质SWV随肾间质纤维化程度的增加而升高,证实剪切波弹性成像技术可反映小儿肾病综合征肾间质损害的程度。血清BMP-7水平随PNS患儿肾间质纤维化程度的增加而减低,而CTGF水平、肾实质SWV则随肾间质纤维化程度的增加而升高,并可间接反映血清BMP-7水平,三者在PNS肾间质纤维化诊治中的有重要的应用价值。
[Abstract]:Objective to detect shear wave velocity (SWV),) of renal parenchyma in children with primary nephrotic syndrome (PNS) and healthy children by quantitative analysis of tissue with acoustic palpation (VTQ). Serum levels of bone morphogenetic protein-7 (BMP-7) and connective tissue growth factor (CTGF) were measured in all children at the same time. The levels of serum BMP-7,CTGF and renal parenchymal SWV, were compared among the groups. The renal parenchymal SWV was compared with the serum BMP-7,. To investigate the value of serum BMP-7,CTGF and renal parenchymal SWV in the diagnosis and treatment of renal interstitial fibrosis in children with PNS. Methods according to the pathological results of renal puncture, 150 cases of PNS were divided into three groups: mild, moderate and severe interstitial fibrosis according to the degree of renal interstitial damage, and 50 healthy children were selected as control group. The level of serum BMP-7,CTGF was detected by enzyme linked immunosorbent assay (ELISA), and the serum BMP-7,CTGF level of renal parenchyma and renal parenchymal SWV, were compared by VTQ technique. Then the serum BMP-7, of PNS group was measured. The correlation between CTGF level and SWV was analyzed. Results there was no significant difference in age, sex and body mass index between PNS group and control group (P0.05). There was no significant difference in BUN,CRE between control group and pediatric PNS group, but there was significant difference in plasma total protein and cholesterol in 24 h Ualb, (P0.05). Serum BMP-7 level: mild moderate group severe group, serum CTGF level: mild moderate group severe group, renal parenchyma SWV value: mild moderate group severe group; There was no significant difference in serum BMP-7,CTGF level and renal parenchymal SWV between mild renal interstitial fibrosis group and control group, while there was significant difference between severe interstitial fibrosis group and control group (P0.05). There were significant differences in serum BMP-7,CTGF level and renal parenchymal SWV between different stages of renal interstitial fibrosis in children with PNS (P0.05). There was a significant negative correlation between serum BMP-7 level and CTGF level (P 0.05), and a significant negative correlation between serum BMP-7 level and renal parenchymal SWV (P 0.05). Serum CTGF level was positively correlated with renal parenchymal SWV (r = 0.702 P 0.05). Conclusion SWV of renal parenchyma in children with PNS increases with the increase of renal interstitial fibrosis. It is confirmed that shear wave elastography can reflect the extent of renal interstitial damage in children with nephrotic syndrome. The serum BMP-7 level decreased with the increase of renal interstitial fibrosis, while the level of CTGF and renal parenchymal SWV increased with the increase of renal interstitial fibrosis, which could indirectly reflect the level of serum BMP-7. They have important application value in the diagnosis and treatment of PNS renal interstitial fibrosis.
【学位授予单位】：青岛大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R726.9;R445.1
本文编号：2325735
[Abstract]:Objective to detect shear wave velocity (SWV),) of renal parenchyma in children with primary nephrotic syndrome (PNS) and healthy children by quantitative analysis of tissue with acoustic palpation (VTQ). Serum levels of bone morphogenetic protein-7 (BMP-7) and connective tissue growth factor (CTGF) were measured in all children at the same time. The levels of serum BMP-7,CTGF and renal parenchymal SWV, were compared among the groups. The renal parenchymal SWV was compared with the serum BMP-7,. To investigate the value of serum BMP-7,CTGF and renal parenchymal SWV in the diagnosis and treatment of renal interstitial fibrosis in children with PNS. Methods according to the pathological results of renal puncture, 150 cases of PNS were divided into three groups: mild, moderate and severe interstitial fibrosis according to the degree of renal interstitial damage, and 50 healthy children were selected as control group. The level of serum BMP-7,CTGF was detected by enzyme linked immunosorbent assay (ELISA), and the serum BMP-7,CTGF level of renal parenchyma and renal parenchymal SWV, were compared by VTQ technique. Then the serum BMP-7, of PNS group was measured. The correlation between CTGF level and SWV was analyzed. Results there was no significant difference in age, sex and body mass index between PNS group and control group (P0.05). There was no significant difference in BUN,CRE between control group and pediatric PNS group, but there was significant difference in plasma total protein and cholesterol in 24 h Ualb, (P0.05). Serum BMP-7 level: mild moderate group severe group, serum CTGF level: mild moderate group severe group, renal parenchyma SWV value: mild moderate group severe group; There was no significant difference in serum BMP-7,CTGF level and renal parenchymal SWV between mild renal interstitial fibrosis group and control group, while there was significant difference between severe interstitial fibrosis group and control group (P0.05). There were significant differences in serum BMP-7,CTGF level and renal parenchymal SWV between different stages of renal interstitial fibrosis in children with PNS (P0.05). There was a significant negative correlation between serum BMP-7 level and CTGF level (P 0.05), and a significant negative correlation between serum BMP-7 level and renal parenchymal SWV (P 0.05). Serum CTGF level was positively correlated with renal parenchymal SWV (r = 0.702 P 0.05). Conclusion SWV of renal parenchyma in children with PNS increases with the increase of renal interstitial fibrosis. It is confirmed that shear wave elastography can reflect the extent of renal interstitial damage in children with nephrotic syndrome. The serum BMP-7 level decreased with the increase of renal interstitial fibrosis, while the level of CTGF and renal parenchymal SWV increased with the increase of renal interstitial fibrosis, which could indirectly reflect the level of serum BMP-7. They have important application value in the diagnosis and treatment of PNS renal interstitial fibrosis.
【学位授予单位】：青岛大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R726.9;R445.1
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