巨噬细胞移动抑制因子在儿童肾小球肾炎中的临床意义

目的：探讨血、尿巨噬细胞移动抑制因子（MIF）水平检测在儿童肾小球肾炎中的临床意义。方法：采用酶联免疫吸附（ELISA）法检测28例增殖性肾炎（系膜毛细血管性肾炎2例、IgA肾病9例、紫癜性肾炎12例、毛细血管内增生性肾小球肾炎5例）、24例非增殖性肾炎（微小病变18例、膜性肾病1例、局灶节段性肾小球硬化5例）、15例健康对照组儿童血清和尿液MIF水平,进行比较并分析其与24h尿蛋白的关系。结果：增殖性肾炎组尿液MIF水平显著高于非增殖性肾炎组及对照组（均P〈0.01）,非增殖性肾炎组尿MIF水平与对照组差异无显著性（P〉0.05）;三组血MIF水平比较差异无显著性（P〉0.05）。增殖性肾炎组患儿中,肾病蛋白尿组尿MIF高于蛋白尿组（P〈0.05）,两组血MIF水平差异无显著性。24h尿蛋白与尿MIF水平呈显著正相关（P〈0.01）,与血MIF无相关性（P〉0.05）。结论：MIF表达上调可能是儿童增殖性肾炎肾损害的重要机制之一,尿液MIF水平检测在监测肾脏损害方面具有较好的临床实用价值。

Clinical significance of macrophage migration inhibitory factor in children glomerulonephritis

Objective： To explore the clinical significance of the detection of the concentration of macrophage migration inhibitory factor （MIF） in serum and urine in children glomerulonephritis （GN）.Methods： Serum and urine MIF was measured with enzyme-linked immunosorbent assay （ELISA） in 28 patients with proliferative nephropathies （2 cases of mesangiocapillary GN,9 ones of IgA nephropathy,12 Henoch-Schonlein purpura nephritis,5 endocapillary proliferative GN）,24 patients with nonproliferative nephropathies （18 cases of minimal change glomerulopathy,1 membranous nephropathy,5 focal segmental glomerular sclerosis） and 15 normal healthy children.Urinary protein was analyzed with the expression of MIF using Spearman correlation.Results： The urine MIF concentration obtained from children with proliferative nephropathies was significantly higher than those from nonproliferative nephropathies and normal controls（P 0.01）.In contrast,serum MIF levels were not significantly different among the three groups （P 0.05）.The level of urinary MIF increased parallelling to the enhancement of urine protein in proliferative nephropathies.The urine MIF concentration in the nephropathy proteinuria group was significantly higher than that in the proteinuria group （P 0.05）.In contrast,the level of serum MIF was not significantly different between two groups（P 0.05）.There was a significant correlation between proteinuria and urine MIF concentration （P 0.01）,but not with serum MIF （P 0.05）.Conclusion： Upregulation of MIF may be an important mechanism in renal injury of children proliferative nephropathies.Urine MIF level may be a predictor to evaluate the degree of renal lesion in proliferative nephropathies.