过敏性紫癜性肾炎患儿血中VEGF、ET-1变化及临床意义

目的 观察过敏性紫癜性肾炎（HSPN）患儿血中血管内皮生长因子（VEGF）与内皮素-1（ET-1）的变化，探讨其与HSPN肾脏病理损害的关系。方法 检测58例HSPN患儿血中VEGF和ET-1的浓度，对其肾病理与肾血管损害进行半定量评分；另设30例健康儿童为对照组。结果 HSPN患儿在轻到中度肾损害时，血清VEGF浓度明显高于对照组；重度肾损害时，则低于对照组（P均〈0．01）。血清VEGF浓度随着血管损害程度加重而下降（P均〈0．01）。血浆ET-1浓度明显高于对照组，并随着肾血管与肾病理损害的加重而递增（P均〈0．01）；血清VEGF与肾病理损害、血管损害及血浆ET-1明显负相关（P均〈0．01）；ET-1与肾病理损害和血管损害明显正相关（P均〈0．01）。结论 VEGF和ET-1在儿童HSPN的发生与发展中发挥一定的作用，血VEGF和ET-1浓度动态变化可用于评价HSPN患儿肾组织及肾血管损伤程度。

Changes and clinical significance of thrombospondin-1 and vascular endothelial growth factor in children with Henoch-Schonlein purpura nephritis

Objective To observe the changes of vascular endothelial growth factor (VEGF) and thrombospondin_1 (ET_1) in children with Henoch_Schonlein purpura nephritis (HSPN) and explore the relationship between VEGF,ET_1 and the pathological impairment of kidney in children with HSPN. Methods The concentrations of VEGF in serum and ET_1 in plasma were detected with enzyme_linked immunosorbent assay and radioimmunoassay,respectively.Pathological impairment of kidney in 58 children with SHPN was assessed by means of semi_quantitative analysis. 30 healthy children served as normal controls. Results The concentration of VEGF in HSPN children with mild to moderate impairment of kidney was significantly higher whereas in children with severe impairment was significantly lower than that in normal controls (P<0.01). The concentration of VEGF decreased with the severity of vascular impairment in kidney.The concentration of EF_1 in HSPN children was significantly higher than that in normal controls and increased with the severity of pathological and vascular impairment in kidney (P<0.01). The concentration of VEGF was negatively whereas the concentration of ET_1 was positively correlated with the severity of pathological and vascular impairment in kidney (r=-0.817,-0.699,-0.769,P<0.01; r=0.735, 0.864, P<0.01). Conclusions VEGF and ET-1 play important roles in the development of HSPN in children.Changes of VEGF and ET-1 concentration can be used to assess the severity of pathological and vascular impairment in children with HSPN.