發(fā)布時(shí)間：2019-03-10 18:50

【摘要】：目的觀察血清半胱氨酸蛋白酶抑制劑C(Cystatin C)和尿中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白(NGAL)、尿腎損傷分子-1(KIM-1)聯(lián)合檢測(cè)對(duì)兒童過(guò)敏性紫癜(HSP)早期腎損傷(HSPN)的診斷效能。方法選擇36例HSPN患兒為HSPN組,36例無(wú)腎炎的HSP患兒為HSP組,22例健康兒童為對(duì)照組。采用膠乳增強(qiáng)免疫比濁法檢測(cè)各組患兒血清Cystatin C,采用ELISA法檢測(cè)各組患兒尿NGAL、KIM-1,采用化學(xué)發(fā)光法檢測(cè)各組患兒尿肌酐(u Cr)。比較各組血清Cystatin C、尿NGAL/u Cr、KIM-1/u Cr。繪制血清Cystatin C、尿NGAL/u Cr、KIM-1/u Cr及三者聯(lián)合檢測(cè)診斷HSPN的受試者工作曲線(ROC曲線),計(jì)算曲線下面積、截?cái)嘀导办`敏度、特異度。結(jié)果HSPN、HSP組患兒血清Cystatin C均高于對(duì)照組(P均0.05),但是HSPN組患兒血清Cystatin C與HSP組相比P0.05。HSPN組患兒尿NGAL/u Cr、KIM-1/u Cr均高于HSP組和對(duì)照組(P均0.05),但是HSP組患兒尿NGAL/u Cr、KIM-1/u Cr與對(duì)照組相比P均0.05。血清Cystatin C、尿NGAL/u Cr、尿KIM-1/u Cr診斷HSPN的ROC曲線的曲線下面積(AUC)分別為0.679(95%CI:0.543~0.815,P=0.023)、0.716(95%CI:0.586~0.846,P=0.006)和0.681(95%CI:0.539~0.822,P=0.022)。選取的截?cái)帱c(diǎn)分別為0.575 mg/L、2.695×10-2ng/mg和0.615×10-2ng/mg,相應(yīng)的敏感度分別為58.3%、61.1%和66.7%,特異度分別為68.2%、77.3%和72.7%。三者聯(lián)合檢測(cè)診斷HSPN的AUC為0.814,敏感性、特異性分別為88.9%、63.6%。結(jié)論血清Cystatin C、尿NGAL、尿KIM-1聯(lián)合檢測(cè)診斷HSPN的效能優(yōu)于單獨(dú)檢測(cè)。
[Abstract]:Objective to observe the serum cysteine protease inhibitor C (Cystatin C) and urinary neutrophil gelatinase-associated lipid delivery protein (NGAL),). Combined detection of urinary renal injury molecule-1 (KIM-1) in children with Henoch-Schonlein purpura (HSP) in the early stage of renal injury (HSPN) diagnostic efficacy. Methods 36 cases of HSPN, 36 cases of HSP without glomerulonephritis and 22 cases of healthy children were selected as HSPN group, HSP group and control group. Serum Cystatin C was detected by latex enhanced immunoturbidimetry, urine NGAL,KIM-1, was detected by ELISA and creatinine (u Cr). Was detected by chemiluminescent method. Serum Cystatin C and urine NGAL/u Cr,KIM-1/u Cr. were compared in each group. The receiver operating curve (ROC curve) of serum Cystatin C, urine NGAL/u Cr,KIM-1/u Cr and their combined detection for diagnosis of HSPN was drawn. The area under the curve, cut-off value, sensitivity and specificity were calculated. Results the serum level of Cystatin C in HSPN,HSP group was higher than that in control group (P0.05), but the serum Cystatin C in HSPN group was higher than that in HSP group. The urine NGAL/u Cr, in P0.05.HSPN group was higher than that in P0.05.HSPN group. KIM-1/u Cr was higher than that in HSP group and control group (P0.05), but urinary NGAL/u Cr,KIM-1/u Cr in HSP group was significantly higher than that in control group (P0.05). The area (AUC) under the curve of serum Cystatin C and urine NGAL/u Cr, urine KIM-1/u Cr for diagnosis of HSPN was 0.679 (95% CI 0.543 渭 0.815, P < 0.023) and 0.716 (95% CI 0.586 渭 0.846, P < 0.05), respectively. P0. 006) and 0.681 (95% CI 0. 539, 0. 822, P = 0. 022). The cut-off points were 0.575 mg/L, 2.695 脳 10-2ng/mg and 0.615 脳 10-2 ng / mg, respectively. The corresponding sensitivity was 58.3%, 61.1% and 66.7%, respectively. The specificity was 68.2%, 77.3% and 72.7%, respectively. The AUC of HSPN was 0.814, the sensitivity and specificity were 88.9% and 63.6%, respectively. Conclusion the combined detection of serum Cystatin-C and urinary NGAL,-urinary KIM-1 is superior to that of single detection in the diagnosis of HSPN.
【作者單位】： 徐州醫(yī)學(xué)院附屬連云港醫(yī)院;
【基金】：連云港市科技局社會(huì)發(fā)展計(jì)劃項(xiàng)目(QN121001)
【分類(lèi)號(hào)】：R725.5;R726.9

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