肾病综合征患儿血清TGF-β1、CTGF、BMP-7检测的临床意义

目的 检测原发性肾病综合征(primary nephrotic syndrome,PNS)患儿血清转化生长因子β1(transforming growth factor β1,TGF-β1)、结缔组织生长因子(connective tissue growth factor,CTGF)、骨形态发生蛋白-7(bone mo...

Clinical Significances of Serum Transforming Growth Factor-β1, Connective Tissue Growth Factor and Bone Morphogenic Protein-7 in Children with Primary Nephrotic Syndrome

Objective To detect the level of serum transforming growth factor-β1（TGF-β1）,connective tissue growth factor（CTGF） and bone morphogenic protein-7（BMP-7） and explore the correlation between their levels and therapeutic effect in children with primary nephrotic syndrome（PNS）.Methods Serum TGF-β1,CTGF and BMP-7 levels were detected by double-antibody sandwich sensitive enzyme-linked immunosorbent assay（ELISA） in 44 children with PNS before treatment and after remission.Twenty normal children were as the normal control group（NC）.Results Compared with NC group,26 patients with sensitive response to prednisone had higher level of serum TGF-β1 before treatment（P0.01）,but no significantly different levels of TGF-β1 after treatment and CTGF,BMP-7 before and after treatment（P0.05）;18 steroid-resistant patients had higher TGF-β1 level before and after treatment（P0.05）,higher CTGF level（P0.01） and lower BMP-7 level after treatment（P0.01）,but no significantly different levels of CTGF and BMP-7 before treatment.Compared with steroid-sensitive children,the levels of TGF-β1,CTGF and BMP-7 in steroid-resistant children had no significant difference before treatment,but TGF-β1 and CTGF levels were higher and BMP-7 were lower after treatment（P0.05 or P0.01）.After treatment,in steroid-sensitive children,TGF-β1 level was significantly decreased（P0.01） and CTGF,BMP-7 had no significant changes;in steroid-resistant children,TGF-β1 and BMP-7 levels were significantly increased（P0.05 or P0.01） and CTGF had no significant changes（P0.05）.In 18 steroid-resistant children,10 had complete remission.After immunosuppressive agents treatment,their TGF-β1 and CTGF levels were higher and BMP-7 level was lowers lower than those of 8 patients without complete remission.There was no correlation between TGF-β1,CTGF,BMP-7,TGF-β1/BMP-7 levels and the proteinuria degree（r=0.12,0.11,-0.24,0.13,P0.05）.A unique correlation was found between CTGF/BMP-7 and the proteinuria degree（r=0.54,P0.05）.Conclusion The levels of serum TGF-β1,CTGF and BMP-7 might be predictive indicators in reflecting disease activity and evaluating the therapeutic effect in patients with PNS.