D-二聚体和胱抑素C及免疫球蛋白在儿童过敏性紫癜中的价值研究

目的探讨D-二聚体、胱抑素C和免疫球蛋白水平检测在儿童过敏性紫癜(HSP)早期肾损害诊断中的应用价值及相关性。方法将80例HSP患儿分为HSP普通型组46例、HSP肾型组34例,另随机选择同期门诊体检儿童60例为对照组,检测受试者血浆D-二聚体、胱抑素C和免疫球蛋白(IgA、IgG、IgM)的水平。结果 3组患儿D-二聚体、胱抑素C和IgA水平比较,差异均有统计学意义(P<0.05);3组IgG、IgM水平比较,差异均无统计学意义(P>0.05)。HSP普通型组、HSP肾型组较对照组D-二聚体、胱抑素C和IgA水平均明显升高,差异有统计学意义(P<0.05);HSP肾型组较HSP普通型组D-二聚体、胱抑素C和IgA水平亦均明显升高,差异有统计学意义(P<0.05)。D-二聚体与胱抑素C呈正相关(r=0.81,P<0.05);D-二聚体与IgA呈正相关(r=0.55,P<0.05);胱抑素C与IgA呈正相关(r=0.68,P<0.05)。结论 HSP的发生、发展是一个多因素参与的复杂过程,D-二聚体、胱抑素C和免疫球蛋白水平对于HSP的诊断具有一定的价值,尤其对患儿肾功能早期损害的诊断,早期联合检测三者的水平,适时地给予预防性治疗,对保护HSP患儿的脏器功能、改善预后具有重要的临床意义,适于临床推广和使用。

Value of D-dimer,Cystatin C and Immunoglobulin in Childhood Henoch-Schonlein Purpura

Objective To discuss the application value and correlation of the detection of D-dimer,Cystatin C and immunoglobulin levels in the diagnosis of early kidney injury in Henoch-Schonlein Purpura(HSP)patients.Methods 80 patients with HSP were divided into HSP normal type group(46 cases) and HSP kidney injury type group(34 cases).Simultaneously,60 physical examination children were randomly chosen as control group.The levels of D-dimer,Cysc C and immunoglobulin(IgA,IgG,IgM) were detected in the three groups.Results Levels of D-dimer,Cysc C and IgA between the three groups showed statistically significant differences(P<0.05);IgG and IgM levels between the three groups showed no statistically significant difference(P>0.05);the levels of D-dimer,Cysc C and IgA in the two HSP groups were significantly increased compared with control group(P<0.05);the levels of D-dimer,Cysc C and IgA in HSP kidney injury type group were significantly increased compared with HSP normal type group(P<0.05).D-dimer was positively correlated to Cysc C(r=0.81,P<0.05);D-dimer was positively correlated to IgA(r=0.55,P<0.05);Cysc C level was positively correlated to IgA(r=0.68,P<0.05).Conclusion The occurrence and development of HSP is a complicated process with multiple factors involved.D-dimer,Cysc C and immunoglobulin levels are valuable in the diagnosis of HSP,especially in the patients with early kidney injury.Detection of these indexes at early stage and timely preventive treatment,which should be clinically recommended and applied,is of great importance to protect the organ function and improve the prognosis.