Henoch Schonlein Purpura Nephritis In Children With Urinary Angiotensinogenmeasured As Malondialdehyde Level And Drug Intervention

Objective The expression level of urinary angiotensinogen and urinarymalondialdehyde was observed in children with henoch schonlein purpuranephritis,and find the relations between urinary angiotensinogen and kidneydamage urinalysis.Investigating renal renin-angiotensin system andoxidative stress whether involved in the kidney damage causing by henochschonlein purpura nephritis,and find mechanisms from renin-angiotensinsystem inhibitors and traditional Chinese medicine syndrome differentiationand treatment.Methods Select158cases of cases in pediatric hospital from September2013to February2014,including allergic purpura(30cases),nephritis(107cases),nephrotic syndrome(20cases).The age of Children range from4to16years old.The experiment is divided into two parts:1The patients weredivided into groups of purpura group(28cases),purpura nephritis group(100cases),nephrotic syndrome group(20cases).Collecting full urine kidneydamage testing by immunonephelometry after inpatients,includingglomerular injury indicators urinary protein/Cr,urinary albumin/Cr,urinaryimmunoglobulin G/Cr and urinary tubular injury indicators,as urinaryretinol/Cr and urine β2microglobulin/Cr,urinary NAG/Cr.analysis of thedifferences between the two groups,and analyzing a correlation betweenurinary angiotensinogen and full with urine indicators of renal damage.2Purpura nephritis divided into Xijiaodihuang group,Xijiaodihuang plusARB/ACEI group,Yupingfeng group,Yupingfeng plus ARB/ACEIgroup.Analyzing changes in24-hour urinary protein excretion,urine angiotensinogen,urinary malondialdehyde before and after treatment,andfind significant difference after treatment,to understand the effects ofdifferent treatment regimens original purpura nephritis in children withurinary for angiotensin.Statistical analysis was performed using SPSS17.0software package.ResultsPart I:Full renal impairment indicators urinalysis and urine MDA/Crdivided into groups of purpura group,purpura nephritis group,nephroticsyndrome group,then add in the urine AGT/Cr original grouping based onthe normal control group(35cases);The data is before treatment.1.Urinary protein/Cr,urinary albumin/Cr,urinary immunoglobulin G/Crin glomerular injury indicators and retinol/Cr and urine β2microglobulin/Cr,NAG enzyme/Cr in urinary tubular injury indicators werecompared between different groups,there are significant differences(P<0.05);Compared urinary CysC/Cr in renal tubular injury amonggroups,purpura group and nephrotic syndrome group,purpura nephritisgroup and nephrotic syndrome group,there were significant differences(P<0.05).Purpura group and purpura nephritis group,there is no significantdifference between sexual and nephritis group(P>0.05).2.Compared urinary AGT/Cr groups.The normal group compared withpurpura nephritis group,purpura group compared with purpura nephritisgroup showed significant differences(P<0.05);Normal group compared withpurpura group,nephrotic syndrome group compared with purpura nephritisgroup,there is no significant difference(P>0.05).3.Compared with urinary MDA/Cr groups,purpura group comparedwith purpura nephritis group,purpura group compared with nephroticsyndrome group,which showed significant differences(P<0.05);Nephroticsyndrome group compared with purpura nephritis group,there is nosignificant difference(P>0.05).4.Urinary angiotensinogen/Cr and urinary protein/Cr,urinaryalbumin/Cr,urinary immunoglobulin G/Cr,urinary retinol/Cr,urinaryCysC/Cr,urinary NAG/Cr,urinary MDA/Cr in nephritis group are positivelycorrelated(P<0.05).Part II:Grouped into Xijiaodihuang group,Xijiaodihuang plus ARB/ACEI group,Yupingfeng group,Yupingfeng plus ARB/ACEI group.1.Compared with treatment,24-hour urinary protein excretion,urinaryangiotensinogen/Cr,urinary MDA/Cr in Xijiaodihuang group,Xijiaodihuangplus ARB/ACEI group were significantly decreased after treatment,there aresignificant differences(P<0.05).2.Compared with urinary AGT/Cr and urinary MDA/Cr after treatmentgroups:Plus ARB/ACEI decreased more significantly(P<0.05) than twogroups did not add ARB/ACEI;Medicine use Yupingfeng soup two mainparties decreased more significantly(P<0.05) than using Xijiaodihuangsoup.Conclusion1.Urinary angiotensinogen correlated with urinary malondialdehyde,tubular andglomerular injury indicators in the pathogenesis of nephritis,which have provedangiotensinogen involved in nephritis kidney damage process.2.Conventional treatment plus ARB/ACEI can better reduce urinary proteinleakage,which play an important role in protecting the kidneys.3.Western conventional therapy plus Yupingfengtang subtraction is effective toreduce the AGT.In western conventional therapy based on the subtractionYupingfengtang plus ARB/ACEI drugs which block the RAS activation better.4.Western conventional therapy plus Yupingfengtang subtraction have a strongerantioxidant effect,and western conventional therapy plus Yupingfengtang based on theuse ARB/ACEI drugs which has better antioxidant.5.Yupingfengtang subtraction has better antioxidant and reduces the secretion ofurine leakage and AGT through its antioxidant effects which may block the intrarenalRAS activation,to protect the kidneys and cure purpura nephritis.