Relationship Among Serum Cystatin C,Fibrinogen,24-hour Urinary Protein Quantity And Renal Pathology In Children With Henoch-Schonlein Purpura Nephritis

BackgroundHenoch-Schonlein Purpura(HSP)is the most common autoimmune small vessel vasculitis disease in children.Henoch-Schonlein Purpura nephritis(HSPN)is the most severe complications of HSP.The key determinant of prognosis is the extent of kidney damage and the golden standard of judging the severity of kidney damage is kidney puncture.In the clinic,many children and their parents are unwilling or unable to accept kidney puncturte in children,and it is difficult to judge the severity of kidney damage.Serum cystatin C,fibrinogen and 24-hour urinary protein quantity are newly discovered indicator to judge the severity of kidney damage.The aim of study to analyze the correlation between kidney pathology classification and three clinical indicators.ObjectiveTo analyze the correlation between kidney pathology classification and three clinical indicators through correlation analysis and comparison between serum cystatin C,fibrinogen,24-hour urinary protein quantity and renal pathology classification of children with HSPN.Studying of Henoch-Schonlein purpura can provide scientific basis for treatment and judgment prognosis.MethodsThe clinical datas of 48 cases of children diagnosed with HSPN by renal biopsy in the Children's hospital of Zhengzhou were reviewed from January 2011 to January 2015.Serum cystatin C was tested by the latex-enhanced immunoturbidimetry,Fibrinogen concentration was tested by turbidimetric measurement,and 24-hour urinary protein quantity was tested by end-point method;The correlation between these indicators and the renal pathology classification was used to test by Pearson and Spearman.ResultsAccording to their pathological results,48 cases of children was HSPN,and 12 cases were classified as class IIa or below,and 12 cases class IIb,and 17 cases class IIIa,and 7 cases IIIb or above.The difference of serum cystatin C level,fibrinogen concentration and 24-hour urinary protein quantity in children with different pathology classifications had statistical significance(P<0.05).As the severity of pathology classification increased the level of every index increased(P<0.05).Serum levels of cystatin C and fibrinogen was positively correlated with 24-hour urine protein and the correlation coefficients were r1=0.51,r2=0.63(P all < 0.05).Fibrinogen and serum cystatin C were positively correlated and the correlation coefficient was r=0.55(P<0.05).Serum cystatin C,fibrinogen,24-hour urinary protein quantity were also positively with pathology classification of the renal and the correlation coefficients were r1= 0.66,r2=0.64,r3=0.68(P all<0.05).Conclusions1.The difference of serum cystatin C level,fibrinogen concentration and 24-hour urinary protein quantity of different pathology classifications had statistical significance among children with purpura nephritis.As the severity of pathology classification increased the level of every index increased.That is to say,If the subjective and objective conditions are not allowed to do the kidney biopsy in the clinica,these three index can be used to judge the severity of renal injury roughly.2.According to the results of the correlation among the three indicators,may draw the conclusion,serum cystatin C,fibrinogen,24-hour urine protein and different pathology classifications were positively correlated.