ESM-1和sICAM-1在兒童過敏性紫癜和紫癜性腎炎中的變化及意義
發(fā)布時間：2018-12-20 22:20
【摘要】：目的研究內(nèi)皮細胞特異性分子-1(ESM-1/Endocan)及可溶性細胞間粘附分子-1(s ICAM-1)在過敏性紫癜(HSP)和紫癜性腎炎(HSPN)血清中的含量,及ESM-1在腎臟組織中的表達情況,尋找可反映HSP腎臟受累的新指標(biāo)并提供理論依據(jù)。方法選取2015年10月至2016年8月于鄭州大學(xué)第一附屬醫(yī)院兒內(nèi)科住院治療的74例患兒為實驗組,其中HSP組32例,HSPN組42例;門診健康體檢兒童21例為對照組。HSPN組又分為腎穿組30例(RB患兒),保守治療者12例;RB患兒進一步分為A組:Ⅱ及以下,8例;B組:Ⅲa,14例;C組:Ⅲb,8例;另選取8例微小病變(MCD)患兒的腎穿組織作為腎組織的正常對照組。應(yīng)用ELISA法檢測研究對象血清ESM-1、s ICAM-1水平,免疫組織化學(xué)染色法檢測ESM-1在腎臟組織中的表達。應(yīng)用SPSS 21.0對結(jié)果進行數(shù)據(jù)分析。結(jié)果1、三組血清ESM-1、s ICAM-1水平HSP組及HSPN組血清ESM-1、s ICAM-1水平明顯高于對照組,且HSPN組高于HSP組,差異均有統(tǒng)計學(xué)意義(均P0.01)。HSPN組大量蛋白尿與非大量蛋白尿之間血s ICAM-1差異具有統(tǒng)計學(xué)意義(Z=-2.575,P=0.01),而血ESM-1差異無統(tǒng)計學(xué)意義(t=-1.01,P=0.318)。RB患兒各病理組別之間的血ESM-1、s ICAM-1水平差異無統(tǒng)計學(xué)意義(χ2=0.298,P=0.585;χ2=1.892,P=0.401)。2、腎小球中ESM-1的表達(AOD值)MCD組、A組、B組及C組腎小球ESM-1表達水平(AOD值)總體分布不同,差異具有統(tǒng)計學(xué)意義(F=10.09,P0.01)。進一步兩兩比較發(fā)現(xiàn),C組AOD值均高于其他各組,且與MCD組、A組、B組之間的差異均有顯著性統(tǒng)計學(xué)意義(均P0.01),而MCD組、A組、B組相互之間AOD值差異未見統(tǒng)計學(xué)意義(均P0.05)。3、ESM-1與病理級別的相關(guān)性RB患兒腎臟ESM-1與病理級別呈正相關(guān)(r=0.617,P0.01);并與血清ESM-1水平成正相關(guān)(r=0.783,P0.01);而RB患兒血清ESM-1水平與其腎臟病理級別無相關(guān)性(r=0.169,P=0.371)。4、ESM-1、s ICAM-1與各臨床指標(biāo)相關(guān)性分析血清ESM-1與血s ICAM-1與成正相關(guān)(r=0.894,P0.01);血ESM-1、s ICAM-1與D-二聚體均呈負相關(guān)(r=-0.320,P=0.013;r=-0.291,P=0.024);血ESM-1、s ICAM-1與尿NAG酶均呈正相關(guān)(r=0.324,P=0.015;r=0.275,P=0.041)。結(jié)論1、ESM-1和s ICAM-1可能均參與了HSP及HSPN的發(fā)生和發(fā)展。2、ESM-1和s ICAM-1可以作為HSP累及腎臟的客觀指標(biāo)。3、監(jiān)測血ESM-1的水平可以間接反映腎臟組織ESM-1的表達情況。
[Abstract]:Objective to study the contents of endothelial cell-specific molecule-1 (ESM-1/Endocan) and soluble intercellular adhesion molecule-1 (s ICAM-1) in serum of Henoch-Schonlein purpura (HSP) and Henoch-Schonlein purpura nephritis (HSPN). And the expression of ESM-1 in renal tissue to find a new index which can reflect the renal involvement of HSP and provide theoretical basis. Methods from October 2015 to August 2016, 74 children who were hospitalized in Department of Pediatrics, first affiliated Hospital of Zhengzhou University were selected as experimental group, including 32 cases in HSP group and 42 cases in HSPN group. HSPN group was divided into renal puncture group (30 cases) and conservative treatment group (12 cases). Children with RB were further divided into group A (8 cases), group B (14 cases) and group C (8 cases). The renal perforating tissues of 8 patients with minimal change (MCD) were selected as the normal control group. The level of serum ESM-1,s ICAM-1 was detected by ELISA and the expression of ESM-1 in renal tissue was detected by immunohistochemical staining. The results were analyzed by SPSS 21. 0. Results 1. The serum ESM-1,s ICAM-1 levels in the three groups were significantly higher in the HSP group and HSPN group than in the control group, and the serum ESM-1,s ICAM-1 level in the HSPN group was higher than that in the HSP group. There was significant difference in blood s ICAM-1 between large albuminuria and non large proteinuria in P0.01). HSPN group (P 0.01). However, there was no significant difference in serum ESM-1 level between different pathological groups (蠂 ~ 2 = 0.298P, P < 0.585). There was no significant difference in blood ESM-1,s ICAM-1 level between different pathological groups (t = -1.01g / min, P = 0.318). The expression of ESM-1 (AOD value) in glomeruli of MCD group, A group, B group and C group were different in total distribution (AOD value), and the difference was statistically significant (F0. 09% P0.01). Further comparison showed that the AOD value of group C was higher than that of other groups, and there was significant difference between group C and group MCD, group A and group B (P0.01), while in group MCD, group A, there was a significant difference between them (P0.01). There was no significant difference in AOD between the two groups (P0.05). 3 the correlation between ESM-1 and pathological grade was positive correlation between renal ESM-1 and pathological grade in RB children (r = 0.617, P0.01). There was a positive correlation between serum ESM-1 level and serum ESM-1 level (r = 0.783, P0.01). However, there was no correlation between serum ESM-1 level and renal pathological grade in children with RB (r = 0.169). The correlation between serum ESM-1 and serum s ICAM-1 was positive (r = 0.894, r = 0.894). P0.01); There was a negative correlation between serum ESM-1,s ICAM-1 and D-dimer (r = 0.320), a positive correlation between serum ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.324), and a positive correlation between serum ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.324, P = 0.015), and a positive correlation between blood ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.320, P = 0.013, P = 0.291, P = 0.024). R = 0.275, P = 0.041). Conclusion 1 both ESM-1 and s ICAM-1 may be involved in the occurrence and development of HSP and HSPN. 2ESM-1 and s ICAM-1 can be used as objective indexes of renal involvement of HSP. Monitoring the level of blood ESM-1 can indirectly reflect the expression of ESM-1 in renal tissue.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.5;R726.9
本文編號：2388503
[Abstract]:Objective to study the contents of endothelial cell-specific molecule-1 (ESM-1/Endocan) and soluble intercellular adhesion molecule-1 (s ICAM-1) in serum of Henoch-Schonlein purpura (HSP) and Henoch-Schonlein purpura nephritis (HSPN). And the expression of ESM-1 in renal tissue to find a new index which can reflect the renal involvement of HSP and provide theoretical basis. Methods from October 2015 to August 2016, 74 children who were hospitalized in Department of Pediatrics, first affiliated Hospital of Zhengzhou University were selected as experimental group, including 32 cases in HSP group and 42 cases in HSPN group. HSPN group was divided into renal puncture group (30 cases) and conservative treatment group (12 cases). Children with RB were further divided into group A (8 cases), group B (14 cases) and group C (8 cases). The renal perforating tissues of 8 patients with minimal change (MCD) were selected as the normal control group. The level of serum ESM-1,s ICAM-1 was detected by ELISA and the expression of ESM-1 in renal tissue was detected by immunohistochemical staining. The results were analyzed by SPSS 21. 0. Results 1. The serum ESM-1,s ICAM-1 levels in the three groups were significantly higher in the HSP group and HSPN group than in the control group, and the serum ESM-1,s ICAM-1 level in the HSPN group was higher than that in the HSP group. There was significant difference in blood s ICAM-1 between large albuminuria and non large proteinuria in P0.01). HSPN group (P 0.01). However, there was no significant difference in serum ESM-1 level between different pathological groups (蠂 ~ 2 = 0.298P, P < 0.585). There was no significant difference in blood ESM-1,s ICAM-1 level between different pathological groups (t = -1.01g / min, P = 0.318). The expression of ESM-1 (AOD value) in glomeruli of MCD group, A group, B group and C group were different in total distribution (AOD value), and the difference was statistically significant (F0. 09% P0.01). Further comparison showed that the AOD value of group C was higher than that of other groups, and there was significant difference between group C and group MCD, group A and group B (P0.01), while in group MCD, group A, there was a significant difference between them (P0.01). There was no significant difference in AOD between the two groups (P0.05). 3 the correlation between ESM-1 and pathological grade was positive correlation between renal ESM-1 and pathological grade in RB children (r = 0.617, P0.01). There was a positive correlation between serum ESM-1 level and serum ESM-1 level (r = 0.783, P0.01). However, there was no correlation between serum ESM-1 level and renal pathological grade in children with RB (r = 0.169). The correlation between serum ESM-1 and serum s ICAM-1 was positive (r = 0.894, r = 0.894). P0.01); There was a negative correlation between serum ESM-1,s ICAM-1 and D-dimer (r = 0.320), a positive correlation between serum ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.324), and a positive correlation between serum ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.324, P = 0.015), and a positive correlation between blood ESM-1,s ICAM-1 and urine NAG enzyme (r = 0.320, P = 0.013, P = 0.291, P = 0.024). R = 0.275, P = 0.041). Conclusion 1 both ESM-1 and s ICAM-1 may be involved in the occurrence and development of HSP and HSPN. 2ESM-1 and s ICAM-1 can be used as objective indexes of renal involvement of HSP. Monitoring the level of blood ESM-1 can indirectly reflect the expression of ESM-1 in renal tissue.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.5;R726.9
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，本文編號：2388503
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