紫癜性肾炎患儿血清和尿液基质金属蛋白酶-9的水平及其临床意义

目的探讨基质金属蛋白酶-9（MMP-9）在儿童紫癜性肾炎（HSPN）中的作用及其与肾脏损害的关系,为防治HSPN提供理论依据。方法收集54例HSPN、54例过敏性紫癜（HSP）患儿以及30例健康对照组儿童的血清和尿液,用ELISA法检测血清、尿液MMP-9水平,以全自动生化分析仪检测HSPN组和HSP组患儿血清β2-MG,以双缩脲比色法检测24 h尿蛋白定量。结果（1）HSPN组血清MMP-9为（259.32±78.38）ng/ml,显著高于HSP组（134.09±49.93）ng/ml（P〈0.05）和对照组（46.25±12.87）ng/ml（P〈0.01）,HSPN组尿液MMP-9为（54.11±15.74）ng/ml显著高于HSP组（30.83±8.73）ng/ml（P〈0.05）和对照组（23.60±4.59）ng/ml（P〈0.01）;（2）根据24 h尿蛋白含量将HSPN组患儿分成三个亚组：A组（尿蛋白〈0.15 g/24 h）、B组（尿蛋白0.15-1.0 g/24 h）、C组（尿蛋白〉1.0 g/24 h）,C组患儿血清和尿液MMP-9含量显著高于A组（P〈0.01）和B组（P〈0.05）,A组与B组间差异无统计学意义（P〉0.05）;（3）HSPN组血清MMP-9与24 h尿蛋白定量、血β2-MG呈正相关（r=0.564,P=0.031;r=0.676,P=0.026）,尿液MMP-9与24 h尿蛋白定量、血β2-MG呈正相关（r=0.787,P=0.023;r=0.536,P=0.015）。结论HSPN患血清及尿液MMP-9增高,可能参与HSPN的发生发展过程。

The Level and Clinical Significance of Secrum and Urine MMP-9 in the Children with Purpura Nephritis

Objective To investigate the role of MMP-9 in the children with Henoch-Schoenlein purpura nephritis （HSPN） ,and provide a basis for the prevention and treatment of HSPN. Methods The serum and urine samples were collected from 54 patients with HSPN, 54 patients with Henoch-Schonlein purpura （lISP） ,and 30 healthy children as control. The content of MMP-9 in the serum and tLrine was tested by enzyme-linked immunosorbent assay （ELISA） ;the levels of β2-MG in the serum were tested by automatic biochemical analysis ,while the total 24 hours-urinary protein from HSP group and HSPN group were tested by biuret colorimetry method. Results （ 1 ） The level of serum MMP-9 in the children with HSPN was （259.32 ± 78.38 ） ng/ml, which was remarkably higher than that of lISP group （ 134.09 ± 49.93 ） ng/ml, （ P 〈 0.05 ） and control group （46.25 ± 12.87 ） ng/nd, （ P 〈 0. 01 ）. The level of urine MMP-9 in the children with HSPN was （ 54. 11 ± 15.74 ） ng/nd, which was significantly higher than that of HSP group （30. 83 ± 8.73 ） ng/ml, （P 〈 0. 05 ） and control group （ 23.60 ± 4.59 ） ng/ml, （ P 〈 0.01 ）. （2） According to content of 24-hour urine protein, the patients with HSPN were divided into 3 subgroups：group A, urinary protein 〈 0.15 g/24 h;group B,0.15 - 1.0 g/24 h;group C, 〉 1.0 g/24 h. The content of MMP-9 in serum and urine of group C was remarkably higher than group A （ P 〈 0.01 ） and group B （ P 〈 0.05 ） ; but there was no significant difference between group A and group B （ P 〉 0.05 ）. （3） There was significantly positive correlation between the level of serum MMP-9 and the serumβ2-MG,the total 24-hours urine protein in HSPN group （ r = 0. 564, P = 0.031 ; r = 0.676, P = 0. 026 ） , there was remarkably positive correlation between the levels of urinary MMP-9 and the serumβ2-MG, the total 24 hours-urine protein in HSPN group, too （ r = 0. 787, P = 0. 023 ; r = 0. 536, P = 0. 159 ）. Conclusion The levels of serum a