小儿肾积水尿细胞因子IGF-1、ET-1、TGF-β1及MCP-1水平的检测及意义

目的 探讨尿细胞因子(胰岛素样生长因子IGF-1、内皮素ET-1、转化生长因子TGF-β及单核细胞趋化蛋白MCP-1)的检测在判定小儿肾积水病肾损害程度中的临床意义.方法 采用酶联免疫吸附法(ELISA)检测41例小儿肾积水病肾尿IGF-1、ET-1、TGF-β1>及MCP-1水平,并以健肾尿作对照.41例同时行病肾组织学检查分级,并与病肾尿IGF-1、ET-1、TGF-β1>及MCP-1水平作相关分析.结果 ①病肾尿IGF-1明显降低为(186.69±24.63)pg/ml,健肾测值为(279.45±31.57)pg/ml,差异有统计学意义(P<0.01);②病肾尿ET-1、TGF-β1、MCP-1明显升高,分别为(49.81±9.08)、(395.91±83.52)、(486.59±89.72)pg/ml,健肾相应测值为(13.21±2.91)、(232.57±32.68)、(328.54±36.81)pg/ml,差异均有统计学意义(P<0.05);③病肾尿IGF-1与病理分级密切负相关,差异有统计学意义(r=-0.839,P<0.01);ET-1、TGF-β1及MCP-1水平与病理分级正相关,但差异无统计学意义(P>0.05).结论 小儿肾积水病肾尿IGF-1水平是从尿细胞因子检测中判定病肾损害程度的理想指标之一.

Clinical significance of urinary cytokines in evaluating the damage severity of affected kidneys in children with hydronephrosis

Objective To evaluate clinical significance of urinary cytokines in evaluating the damage severity of affected kidneys in children with hydronephrosis. Methods The pyelic urinary in-sulin-like growth factor-1 (IGF-1), endothelin-1 (ET-1), transforming growth factor-β1 (TGF-β1) and monocyte chemoattractant protein-1 (MCP-1) in affected and healthy kidneys (as controls) were de-tected in 41 children with congenital hydronephrosis by enzyme-linked immuno-sorbent assay (ELISA). Pathologic changes of the affected kidneys were graded and the correlations of pathologic grades with urinary level of IGF-1, ET-1, TGF-β1 and MCP-1 were analyzed by Spearman's test. Re-sults The level of urinary IGF-1 in healthy group was (279. 45 ± 31.57) pg/ml, which was signifi-cantly higher than that in hydronephrosis group ( ( 186. 69 ± 24. 63) pg/ml). However, the levels of u-rinary ET-1, TGF-β1 and MCP-1 in healthy group was significantly less than those in hydronephrosis group ((13.21±2.91 vs 49.81 ±9.08) pg/ml, (232.57±32.68 vs 395.91 ±83.52) pg/ml and (328. 54 ± 36. 81 vs 486. 59 ± 89. 72) pg/ml, respectively). Negative correlation was noted between u-rine IGF-1 levels and pathologic grades (P<0. 01 ). Conclusions Urinary IGF-1 is an ideal marker in evaluating the damage severity of affected kidneys in children with hydronephrosis.