Changes In Plasma MPO,MDA,SOD And T-AOC In Acute Stage Of Children With Henoch-schonle Purpura And Their Clinical Significance

Objective Henoch-Schonlein purpura(HSP) is the most common systemic vasculitis in childhood, which its exact etiology and pathogenesis is not clear.Studies have shown that oxidative stress plays a important role in rheumatic autoimmune diseases and pathogenesis and pathological damage process of glomerular diseases. However, the home and abroad have less attention to the role of oxidative stress induced pathological and pathology injury processes in children with Henoch-Schonlein purpura. In order to further study the pathogenesis of HSP,we investigate the changes in plasma myeloperoxidase(MPO),malondialdehyde(MDA), superoxide dismutase(SOD) and total anti-oxidant capability(T – AOC) in acute stage of children with Henoch-Schonle purpura,and the relationships with children of different types of clinical manifestations and kidney damage, to provide a theoretical basis for the treatment of the antioxidant therapy and the prevention and treatment of vital organ damage in acute stage of children with Henoch-Schonle purpura.Methods 1. Research Subjects A total of 80 children who were all the first onset,hospitalized with HSP from Nov.2013 to Apr.2014 in our hospital were divided into 3 groups:general HSP group(40 cases), gastrointestinal HSP group(20 cases), and HSP nephritis(HSPN)group(20cases). The patient population consisted of 53 boys and27girls.Age at disease onset range from 3 to 14 years,with a mean of 9.08±2.45 years. Sixteen healthy children were included as healthy control group.Healthy control group consisted of 11 boys and 5 girls.Age range from3 to 14 years,with a mean of 8.06±2.69 years.2. Observation indexes and detection methods Oxidative stress indexs detection: The level of plasma MPO,T- AOC were measured by colorimetry, MDA measured by thiobarbituric acid,SOD measured by Hydroxylamine method. The next morning after all subjects into hopital,extract 2m L peripheral venous blood into EDTA anticoagulation tube,2000r/min,centrifuge 15 min and keep plasma into-80℃ refrigerator.24h urinary protein detection: 24 h urinary protein excretion in HSPN group during active stage were detected by using Germany Roche fully automatic biochemical instrument immune turbidimetry.3. Statistical analysis: Statistical analyses were done using the SPSS 17.0. Measurement data were expressed as means ± standard deviations,the means among groups were compared using analysis of variance, further pairwise comparison using LSD-t test; Count data were expressed as a percentage, χ2 test was used to determine the differences among groups. Pearson’s correlation analyses were used to evaluate relationships between various variables. A P value less than 0.05 was considered significant.Results 1.The changes in plasma MPO, MDA, SOD and T – AOC in different groups The plasam MPO,MDA levels were significantly increased and SOD,T-AOC activitieswere decrease in HSP patients of active stage compared with the control subjects(P<0.05); The plasam MPO,MDA levels were obviously elevated and SOD,T-AOC activities were lowered in HSPN group compared with general HSP group,gastrointestinal HSP group and the control subjects(P<0.05). The MDA level was higher in gastrointestinal HSP group than general HSP group and the control subjects(P<0.05; The plasam MPO,MDA levels were significantly increased and SOD,T-AOC activities were decrease in general HSP group of active stage compared with the control subjects(P<0.05).2. Correlation between levels of plasma MPO,MDA and 24 h urinary protein excretion in HSPN group Significant positive correlations were found between MPO and 24 hours urinary protein excretion(r=0.695, P<0.05) and between MDA and 24 hours urinary protein excretion(r=0.559, P<0.05) in the HSPN group.Conclusions The imbalance was found between oxidation system and antioxidant system in acute stage of children with Henoch-Schonle purpura. There is correlation between oxidative stress intensity and degree of renal damage and proteinuria in children with Henoch-Schonle purpura.Oxidative stress change may be involved in the process of the progression and pathological damage of vital organs,such as kidney in children with Henoch-Schonle purpura.