| Objective: Henoch-Schonlein purpura is the most common allergicdisease with systemic small vessel in childhood, and its prognosis is oftendecided by the degree of renal injury. In the early course of the disease there isno clinical renal manifestation, and traditional detections such as urine andrenal function have no abnormalities, but the renal has minor injured. Urinemicroprotein is that its level exceeds the normal but could not be detected bytraditional ways, and it is sensitive to reflect the renal injury in the early HSP.In this study, we have to investigate the significance of urinary microprotein inearly renal injury by detect the urine microprotein and compare them.Method:1object: Choose50patients first diagnosed as HSP betweenJune2011to December2011hospitalized in HeBei Medical University2ndAffiliated Hospital for research objects, who accept treatment by anti-infection,anticoagulation and anti-anaphylaxis, while the control group involed30ofhealthy children with age matched.Inclusion and exclusion criteria:(1) the cases with research objects metthe diagnosis standards of HSP with Zhu Futang 《Textbook of Pediatrics》(Version7).(2) urine detected positively, and (or) OB positive, or any kindof urine microprotein detected positively is thought early renal injury.(3)exclusion criteria:①primary kidney disease, such as NS, Glomerulonephritis.②other renal injury caused by immune system disease, such as SLE,Kawasaki disease, JIA.③history of taking long-term hormone, immunosuppressant or resent taking renal injury drug.④children with renaldysfunction caused by renal or vascular abnormalities and injury.⑤childrenwith underlying disease of hear, lung, brain.⑥children with coagulationabnormalities caused by congenital coagulation disorder or other reasons.(4) the control group exclude organic and immune disease also and could not beinfected in these3months.2scheme: get know the incidence of renal injury by detecting the level ofmALB, TRF, NAG in research group; learn the significance of urinemicroprotein detection in renal injury with early HSP by compare the positiverate with urine detection; observe the change of the microprotein (monitorthem weekly, for4weeks), to handle their tendency and juvenation.3detect methods:3.1urine detection: by Combio scanxL urine detect implement3.2urine mALB: i-GHROMA Reader IMF analysator made by BoditechMed Inc Company of KOREA.3.3TRF NAG: with method of ELISAProvide the positivity when urinary protein and (or) OB positive andmALB>20mg/L, TRF>1.0mg/L, NAG>15U/L.4SPSS13.0was used to analyze if the characteristics above had statisticaldifferences between different groups, when P<0.05it has statistic significance.Results:1in the50patients of research group,29were male,21werefemale, the rate between male and female is1.21:1, and the mean age is7.13±2.35years, in the30patients of control group,18were male,12werefemale, and the age, sex between the two group had no significant difference(P>0.05).2the level of the urine microprotein in control group (midian) were6.12mg/L,0.64mg/L, NAG2.4U/L, and the positive rate of urine detection inHSP patients at different weeks were12%,16%,16%,8%.3the mALB level (M) was39.63mg/L in the1st week, and roach highestin the2nd week(68.77mg/L)(P<0.05), then descent at the3rd week, in the4thweek it dropt to the normal level, but also higher than control(P<0.05); thepositive rate at different times were56%,64%,48%,22%, and all higher thanthat of urine detection(P<0.05).4the TRF level (M) was32.16mg/L in the1st week, and roach highest inthe2nd week(57.55mg/L)(P<0.05), then descent at the3rd week, in the4th week it dropt to the normal level(1.13mg/L), but also higher thancontrol(P<0.05); the positive rate at different times were62%,68%,50%,20%, and all higher than that of urine detection(P<0.05).5the NAG level (M) was32.39U/L in the1st week, and roach higher inthe2nd week, to highest in the3rd week (69.38U/L)(P<0.05), then dropt tothe normal level in the4th week; the positive rate at different times were54%,56%,60%,20%, and all higher than that of urine detection(P<0.05)6the positive rate of combine detection weekly were74%,84%,70%,28%, and the highest rate was in the2nd week(P<0.05), and were all higherthan that detected respectively (P<0.05).Conclution:1urine mALB, TRF, NAG combined detection could beused as the diagnostic index in early renal injury with HSP for its highsensitivity.2urine mALB, TRF, NAG combined detection has important evaluatedsignificance for treatment effect in early renal injury of HSP patients.3the level of urine microprotein in a bulk of children with HSP who hadlight renal injury rebounded normal in the4th week... |
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