IGF-1,TGF-β1水平变化与过敏性紫癜患儿肾损害的关系

目的探讨胰岛素样生长因子-1(IGF-1)和转化生长因子-β1(TGF-β1)在过敏性紫癜性肾损害(HSPN)患儿发病中的作用。方法选择过敏性紫癜(HSP)患儿135例,根据是否伴有肾损害分为HSP组和HSPN组,比较各组血IGF-1,TGF-β1,胱抑素C(Cys C)、肌酐(SCr)和尿素氮(BUN)含量,并比较不同病理分级的HSPN患儿血IGF-1,TGF-β1和Cys C含量,分析HSPN组血IGF-1,TGF-β1和Cys C含量的相关性。结果血IGF-1,TGF-β1和Cys C含量在对照组(117.2±18.8 ng/L,164.2±18.4 ng/L,0.9±0.2 mg/L),HSP组(131.7±19.6 ng/L,282.1±28.3 ng/L,1.1±0.2 mg/L),HSPN组(205.3±24.5 ng/L,489.2±32.7 ng/L,1.3±0.3 mg/L)呈逐渐增加趋势(F=4.824~45.066,P值均0.01),HSP组、HSPN组均高于对照组(q=3.397~58.931,P值均0.01),且HSPN组高于HSP组(q=16.997,35.193,P值均0.01),差异均有统计学意义。HSPN患儿血IGF-1(Ⅱ级175.6±20.4 ng/L,Ⅲ级198.5±23.3 ng/L,Ⅳ级241.7±25.1ng/L),TGF-β1(Ⅱ级392.8±38.9 ng/L,Ⅲ级481.3±03 ng/L,Ⅳ级537.6±42.9 ng/L),Cys C(Ⅱ级1.1±0.3 mg/L,Ⅲ级1.3±0.4 mg/L,Ⅳ级1.6±0.4 mg/L)含量随着肾脏病理分级的增加而升高(F=6.594~28.317,P值均0.01),肾脏病理分级为Ⅵ级的患儿血IGF-1,TGF-β1和Cys C含量高于Ⅱ级和Ⅲ级患儿(q=2.415~11.818,P0.05或P0.01),而Ⅲ级患儿高于Ⅱ级患儿(q=2.577~6.244,P0.05或P0.01),差异均有统计学意义。HSPN患儿血IGF-1,TGF-β1含量与Cys C含量呈正相关(r=0.648,0.719,P0.05),而血IGF-1含量与TGF-β1含量呈显著正相关(r=0.748,P0.05)。结论 IGF-1,TGF-β1共同参与了HSPN发病,并且与病理损害程度相关。