血清胱抑素C纤维蛋白原及24小时尿蛋白定量对紫癜性肾炎儿童肾损伤程度的评估效果

目的 探讨血清胱抑素C （CysC）、纤维蛋白质（Fbg）及24小时尿蛋白定量对紫癜性肾炎（HSPN）儿童肾损伤程度的评估效果。方法 以苏州新世纪儿童医院2014年1月至2016年12月收治的86例HSPN患儿为研究对象。入院后检测血清Cys C、Fbg和24小时尿蛋白定量，同时进行肾脏穿刺活检评估肾脏损害严重程度。分析血清CysC、Fbg及24小时尿蛋白定量与肾损伤程度的关系。结果 随着肾小球病理分级和肾小管间质病理分级提高，血清CysC、Fbg及24小时尿蛋白定量均上升（P<0.05）；不同肾小球病理分级和和肾小管间质病理分级患儿血清CysC、Fbg及24小时尿蛋白定量比较，差异均有统计学意义（P<0.05）。Spearman相关分析结果显示，血清CysC、Fbg及24小时尿蛋白定量与肾小球病理分级（r=0.569，r=0.633，r=0.685，P<0.05）和肾小管间质病理分级（r=0.613，r=0.715，r=0.739，P<0.05）均存在正相关性。结论 血清CysC、Fbg及24小时尿蛋白定量与HSPN患儿肾脏损伤严重程度密切相关，且检测方法简单、无创，易于获得，可作为肾脏损伤筛查的指标。

Evaluation effects of serum cystatin C and fibrinogen and 24-hour urinary protein on renal damage in children with HSPN

Objective To discuss the evaluation effects of serum levels of cystatin C (CysC) and fibrinogen(Fbg) and 24-hour urinary protein on renal damage in those children with Henoch-Schonlein purpura nephritis(HSPN).Methods From Jan 2014 to Dec 2016, eighty-six patients with HSPN ever treated in our hospital were collectedas the study objectives. After admission, their serum levels of CysC and Fbg and 24-hour urinary protein were measured, and the severity of renal damage was assessed through renal puncturebiopsy. Then the relationship between results of CysC and Fbg and 24-hour urinary protein and severity of renal damage was analyzed.Results With the pathological grades of renal glomeruli and renal tubulointerstitium being higher, the serum levels of CysC and Fbg and 24-hour urinary protein allincreased significantly (P<0.05). There were significant differences in the CysC and Fbg levels and 24-hour urinary protein among children with different pathological grades of renal glomeruli and tubulointerstitium (P<0.05). Spearman correlation analysis showed that serum CysC and Fbg levelsand 24-hour urinary protein were significantly positively correlatedwiththe pathological grades ofrenal glomeruli (r values of 0.569, 0.633, 0.685, P<0.05) and renal tubulointerstitium (r values of 0.613, 0.715, 0.739;P<0.05).Conclusion The serum CysC and Fbg levels and 24-hour urinary protein in those HSPN children are closely related to the severity of renal damage.Since they could be detected and obtained simply and noninvasively,so they might be used as an indicator for renal damage screening.