The Clinical Significance Of High-sensitivity C-reactive Protein In Children With Primary Nephrotic Syndrome

Objective: At present, an important clinical significance of high sensitivity C-reactive protein (hs-CRP) in cardiovascular disease has been generally recognized, and its role in kidney disease is increasingly being recognized. We have observed that serum levels of hs-CRP of the primary nephrotic syndrome (PNS), and to explore the relationships of hs-CRP and the PNS including its complications. In the course of the disease, by observing hs-CRP and other related indicators of the PNS in this clinical trial, we would understand the correlation the hs-CRP and PNS's occurrence, development, recurrence and prognosis whether or not, to reveal the pathogenesis associated with inflammation.Methods:1 Research objectsDecember 2008 to december 2009, from my hospital inpatients of renal disease group, and consistent with the diagnostic criteria for PNS. By screening, there are 167 cases into the research group (male 121, female 46), age 6.4±5.3 years. Replacement of the same period, 130 cases (male 90, female 40) of healthy children (selected from West Community of Shijiazhuang and the kindergarten which is belonged the sixth factory of cotton textile) as the control, age 7.3±4.2 years.2 Experimental methods and group2.1 Detection index and methodsFor each object to avoid strenuous exercise within 24 hours, after 12 hours fasting overnight, resting 15 minutes, we would applied South Korea BoditechMed Inc's i-CHROMA hs-CRP immune fluorescence analyzer to measure hs-CRP. The reagents is hs-CRP-specific detection reagents of the company's production, and detection methods is the double-antibody sandwich method (detection range and detection sensitivity were 0.5~200mg/L and 0.1mg/L; normal reference values: hs-CRP<1.0mg/L; CRP<10mg/L). The children of PNS group were detected albumin (Alb), total cholesterol (TC), blood urea nitrogen (BUN), C3 and other indicators by using Hitachi 7600 automatic biochemical analyzer, and were blooded in the morning, while they leaved the 24 hours urine in the same day, recorded total urine volume, and determined the 24 hours urinary protein (24hUPro) by sampling of the colorimetric. Measure the PNS children's a white corpuscle (WBC) and blood platelet (PLT) of routine blood test, and erythrocyte sedimentation rate (ESR) by making use of automatic blood analyzer, respectively XS-800i Sysmex and Italy ELACTA LAB Monitor-20 ESR instrument.2.2 Grouping and research methodsThe 167 children with PNS as the PNS group and the brank group (130 normal children) would been measured the value of hs-CRP. Application of non-parametric rank sum test statistics are different in comparison (Note: There are the uncertain value in the two group of measurement data of hs-CRP, such as <0.5mg/L, so we would used rank sum test).In accordance with the above clinical manifestations, the 167 PNS children were divided into simple nephrotic syndrome, nephritis nephrotic syndrome groups. The group of simple nephrotic syndrome is a total of 125 cases, and nephritis nephrotic syndrome group is a total of 42 cases. Measured the hs-CRP of two groups. Application of non-parametric rank sum test statistics are different in comparison.By glucocorticoid response, the 167 PNS children were divided into steroid-sensitive nephrotic syndrome group of a total of 121 cases, steroid-resistant nephrotic syndrome group of a total of 38 cases, another, steroid-dependent nephrotic syndrome group were 42 cases. Measured the hs-CRP of three groups. Application of multiple samples comparison rank sum test to compare whether the differences.According to renal function being abnormal whether or not, the 167 PNS children were divided into abnormal and normal groups. Abnormal group is 42 cases, and normal group is a total of 125 cases. Comparing hs-CRP, Alb, TC, C3, 24hUPro and other indicators of the two groups, there are the differences whether or not. Using x±s to express measurement information, the indicators of the normal and the abnormal group were compared by the independent samples t test.We will be the 167 PNS children's ESR, WBC, PLT various indicators and hs-CRP for Pearson correlation analysis, to find the hs-CRP-related factors. The above statistical treatment will is using SPSS 13.0 statistical software for analysis. If P<0.05, there is the difference statistically significant.Results:1 The hs-CRP of the children with nephrotic syndrome group were higher (P<0.01), and the hs-CRP levels of nephritis nephropathy group and simple nephrotic group were no significant difference (P>0.05). Hormone-sensitive nephrotic group, steroid-resistant nephrotic group and steroid-dependent nephrotic group, the hs-CRP levels of which were no significant difference (P>0.05).2 The TC, Alb, hs-CRP of abnormal group was significantly higher than normal group, with statistically significant difference (P<0.01). 24hUPro of abnormal renal function group is also higher than the normal group, with statistically significant difference (P<0.05). Normal group and abnormal group's C3 was no significant difference (P>0.05). 3 Between hs-CRP and ESR, WBC, PLT of PNS group are no correlation (P>0.05).Conclusion:1 The bodies of the PNS children presences the micro-inflammatory response, while, the serum hs-CRP increased is the representative of the micro-inflammatory response. Nephritis nephrotic syndrome and simple nephrotic syndrome in children are no significant difference about the above micro-inflammation. Hormone-sensitive kidney disease, hormone-resistant renal disease and steroid-dependent nephrotic disease are no significant difference in the above micro-inflammation.2 While the PNS children developed to renal abnormal, the hs-CRP levels were significantly higher than the normal group. That shows that hs-CRP levels are certainly relevant with the occurrence, development and prognosis of PNS.3 Hs-CRP, routine blood test, and ESR, all the above three reflect the micro-inflammation in patients with PNS.That had no correlation.