儿童过敏性紫癜可能发生早期肾损害的临床研究

目的探讨联合检测血清胱抑素C（Cysc）与尿免疫球蛋白及转铁蛋白，在儿童过敏性紫癜（HSP）早期肾脏损害诊断中的临床价值。方法按内生肌酐清除率将100例确诊为过敏性紫癜患儿分为两组，其中B组58例不伴有肾损害，c组42例伴有肾损害。另以同年龄门诊体检健康儿童50例为正常对照组，即A组，应用散射免疫比浊法进行检测尿免疫球蛋白及转铁蛋白及液相透射比浊法测定CysC。结果与对照组比较，过敏性紫癜患儿血胱抑素C及尿免疫球蛋白及转铁蛋白明显升高，差异有统计学意义（P〈0．05），伴有肾损害组升高更明显。结论CysC联合尿免疫球蛋白及转铁蛋白定量检测，为临床判断HSP早期肾功能损伤提供了有力的证据，是一种简单、准确并且实用的无创性检测方法。

Clinical Study of Early Renal Damage May Occur in Children with Henoch- Schonlein Purpura

Objective By combined detection of serum cystatin C （Cys C） and urinary immunoglobulin and transferring to investi- gate its clinical value in the diagnosis of early renal damage in children with Henoch-Schonlein purpura （HSP）. Methods Accord- ing to the endogenous creatinine clearance rate, 100 cases of children diagnosed with Henoch-Schonlein purpura were divided into two groups, group B included 58 patients without renal damage, 42 cases in group C with renal damage. Other 50 cases of healthy children with the same age underwent health examination in outpatient were selected as the normal control group, group A. Neph- elometric immunoassay was used to detect urinary immunoglobulin and transferring, and liquid transmission turbidimetry was used to detect CysC. Results Compared with those of the control group, cystatin C and urinary immunoglobulin and transferrin increased significantly in children with Henoch-Schonlein purpura （P〈0.05）, and which increased more obviously in renal injury group. Conclusion CysC combined with urinary immunoglobulin and transferrin quantitative detection, provides strong evidence for the clinical diagnosis of early renal damage of HSP, and it is a simple, accurate and practical noninvasive detection method.