Study Of Serum PDGF-BB In Children With IgA Nephropathy

Objective:IgAN is the most common kind of gromerular disease .In the past,it was thought to be a good prognosis, but now we find that it is evolutional and about 15-40% of it developed to ESRD.Renal disopsy has been an important technology for inspeciving the development of kidney,However,it has risk to a certainty as an invading examination.Some researchers are searching for the serum indicators,which can partly reflect renal pathology.To combines clinical cases with renal biopsy,by assaying transforming PDGF-BB in children with IgAN。The study purposes are as following .1.To investe the change of serum Platelet derived grouth factor in different renal pathology type in children with IgA nephropathy .2.To explore that if the level of serum PDGF-BBcan act as the predictors in estimating degree of illness and prognosis in children with IgA nephropathy.Methods: 30 children who were proved to be IgA nephropathy by biopsy were studied.There were also 21 children with none- IgA nephropathy as control groupⅠand 15 heathy children control groupⅡ.There was no significant difference in age and sexual composition among each group.All children were taken in for making serum.Monoclonal ELISA detected PDGF-BB.Serum BUN,Cr and 24h urinary protein were measured. Acorrding patholgical degree constituted by WHO in 1982 the IgA nephropathy group divided into five degreesⅠ,Ⅱ,Ⅲ,Ⅳ,Ⅴ。(Ⅰ,Ⅱwere light patholoic chang group,Ⅲ,Ⅳwere moderate patholoic chang group,Ⅴwas severe patholoic chang group)The IgA nephropathy group respectively examined above indexe before treatment and after treated for 3 mongths,divided into complete remission group,part remission group and no response group according the therapy effect. The IgA nephropathy group divided into two groups according if having hypertension or not.Results were expressed as the mean±SD,data were analyzed using SAS program 6.12for windows software.Analysis of variance,t test,linear regression and analysis of linear correlation were used to compared mean valuses.AP Value less than 0.05 was considered statistically significant.Results:1 The serum level of PDGF-BB in IgA nephropathy group were significantly higher than that in none- IgA nephropathy group ( 869.16±200.73 vs. 447.38±186.38ng/l t= 7.602 ,p<0.05)2 The serum level of PDG-BBF in IgA nephropathy group were significantly higher than that in natural conrol group(869.16±200.73 vs. 247.35±55.79ng/l t=11.712 ,p<0.05) 3 There were 4 cases in severe patholoec change group ,16 in moderate patholoec change group and 10 in light patholoec change group。The serum level of PDGF-BB in the severe patholoec change group were significantly higher than that of the moderate patholoec change group (1214.44±91.48 vs. 912.85±97.20ng/l,t=5.604,p<0.05); The serum level of PDGF-BB in the severe patholoec change group were significantly higher than that of the light patholoec change group ( 1214.44±91.48 vs. 661.13±82.66ng/l,t=11.100,p<0.05); The serum level of PDGF-BB in the moderate patholoec change group were significantly higher than that of the light patholoec change group(912.85±97.20 vs. 661.13±82.66ng/l,,t=6.786,p<0.05.)4 The IgA nephropathy divided into no response group,part remission group and complete remission group according the therapy effect.The serum level of PDGF-BB in the no response group : it is 1147.74±129.99ng/l before treatment and 949.17±93.92ng/l after treatment. The serum level of PDGF-BB in the part remission group : it is 888.36±120.78ng/l before treatment and 327.42±147.69ng/l after treatment. The serum level of PDGF-BB in the complete remission group : it is 736.69±133.53ng/l before treatment and326.55±187.22ng/l after treatment.The no response group is significantly higher than the part remission group(t=4.046,p<0.05,) , significantly higher than the complete remission group (t=6.330,p<0.05)and significantly higher than the control groupⅡ(t=22.70,p<0.05) before treatment.;The no response group is still significantly higher than the part remission group(t=9.188,p<0.05) ,significantly higher than the complete remission group (t=7.658,p<0.05) and significantly higher than the control groupⅡ( t=21.348,p<0.05 ) after treatment ; It was no significant difference in no response group after and before treatment(t=3.621 ,p>0.05). The part remission group was significantly higher than the clmplete remission group( t=2.850,p<0.05)and significantly higher than the control groupⅡ(t=18.0071,p<0.05) befor treatment. There was no significant difference between part remission group and clmplete remission group after treatment(t=0.0122 ,p>0.05). There was no significant difference between part remission group and the control groupⅡafter treatment (t=1.921,p>0.05).It was significantly higher before treatment than after treatmen(tt=18.6550,p<0.05).The clmplete remission group were significantly higher than control groupⅡbefore treatment(t=12.936,p<0.05), and after treatment there was no significant difference with the control groupⅡ(t=1.5675,p>0.05);, The clmplete remission group Before treatment were significantly higher than after treatment(t=8.554,p<0.05)。5 IgA nephropathy divided into two groups according if having hypertensive or not. The serum level of PDGF-BB of the hyper-tensive group was significant higher than that of no- hypertensive group(1114.74±115.89 ng/l vs. 785.89±135.60ng/l,t=6.280,p<0.05)。6There were positive correlation between PDGF-BB and 24h pro(r=0.6732).7The serum level of PDGF-BB did not correlate with BUN and Cr.Conclusions: 1The serum level of PDGF-BB in children with IgA nephropathy is higher than that of none- IgA nephropathy and higher than that of nomal control group.2As the pathological sevevety increased in children with IgA nephropathy ,the level of PDGF-BB was raised,which implied the level of serum PDGF-BB might reflect damages of renal pathology indirectly.3The serum level of PDGF-BB in no response group was significantly higher than that of the remission group,The serum level of PDGF-BB in the group with hypertensive was significantly higher than that of the group with no- hypertensive. As the urinary protein was increased in children with IgA nephropathy,the level of PDGF-BB was raised.4 Monitoring the dynamic change of serum PDGF-BB can assess the effect and evaluate the prognosis of IgA nephropathy。It is an evidence to therapatic effect and prognosis,which was a simple ,convenient and not traumatic measurement maker.