| Objective:Detect the positive rate urine level of MA andβ2-MG in HSP patients, so that to know the clinical significance of MA in the early renal injury. Observe the clinical efficacy of low molecular heparin in HSP.Methods:(1) Fresh medistream urine level of MA andβ2-MG were dectected in89 patients with HSP the next day admitted to hospital. Routine urine test, 3hAddis count, and other routine screening were detected at the same time. Compare the positive rate of MA,β2-MG, urine routine,3hAddis count and one or two unusual in MA in patients whose renal function and 24h urine protein were normal.4 of 89 patients relapse within half a year. These recurrences were caused by infection or allergy.(2) 89 children in HSP were treated with LMWH. the LMWH dosage is 60-100iu/kg·d,1 time a day, lateral upper arm subcutaneously qd for 7-10 days. Compare the three groups of urine MA, urinaryβ2-MG levels, Addis count and urine routine before treatment and after treatment, and observe the clinical efficacy; Compare the urine MA, urinaryβ2-MG levels, Addis count and urine routine at the time after treatment of 10 days and 7 days; Pay attention to the possible side affects such as process of bleeding, thrombocytopenia, liver damage, skin rashes and other adverse reactions, and take positive symptomatic treatment.Results:(1)①The positive rate of urine routine, urine Addis count and one or tow unusual in MA were 23.6%,29.2% and 74.2% respectively. The positive rate of urine protein was significantly higher than the other two indicators (P<0.01); 50 out of 66 patients whose urine MA were abnormal have a normal urine test. It suggests that these patients'kidney damage has already occurred even if the urine routine were negative.②The positive rate of MA andβ2-MG in urine were 60.7% and 34.8% respectively. The positive rate of urinary protein in urine higher than the MA, urineβ2-MG, the differences were statistically significant; The positive rate of urinary MA was higher than that of urineβ2-MG. It suggests that a combination test of urine MA can prompte and increase the positive rate of diagnosis, and early kidney damage was glomerular-based.(2)①The urinary MA andβ2-MG in children with HSP were higher before treatment than the normal control group, And there were highly significant difference in urinary MA (p<0.01), urinaryβ2-MG were significantly different; The two aspects were decreased after treatment, the differences were statistically significant; urinaryβ2-MG decreased the most significant (p<0.01); but it was still higher than the normal control group after treatment, the differences were statistically significance②The number of abnormal cases in urine was 21 and 10 before and after treatment; Addis count were 26 and 14 respectively. The number of abnormal cases were less than those before treatment.③The number of cases of improvement in urinary MA, urinaryβ2-MG, Addis count and urine routine after a 10-day treatment were more than a 7-day treatment, but there were no statistically significant differences (P>0.05).Conclusion:(1) The urine protein test can be used as early renal damage in children with HSP diagnosis indicators; joint-related protein detection can improve the accuracy of diagnosis; urine protein, the main change to MA increased, indicats that as of early kidney damage in glomerular Lord.(2)LMWH can significantly reduce the urinary protein excretion to reduce kidney damage in children with HSP, and have a remarkable effect of the protection and restoration in renal function.
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