Effects Of Invigorating Kidney And Promoting Blood Circulation On NGAL And L-FABP In Children With Primary Nephritic Syndrome

Objectives:To further improve the pathogenesis of pediatric primary nephritic syndrome(PNS)and the action mechanism of traditional Chinese medicine-Shenkangling for invigorating kidney and activating blood circulation and then achieve the purpose of improving clinical efficacy and decreasing adverse drug reaction through observing the influence of intervening pediatric PNS with invigorating kidney and activating blood circulation method on neutrophil gelatinase associated lipocalin(NGAL)and liver-type fatty acid binding protein(L-FABP).Methods:40 outpatient and ward the PNS(simple type,frequent relapses)pediatric patients were selected.Random number table method was adopted to divide the cases into treatment group with integrated traditional Chinese medicine and western medicine(Group A)with 20 cases and control group with western medicine treatment(Group B)with 20 cases and select 20 cases of healthy children as normal group(Group C).Group B adopted pure western medicine treatment and Group A taken additional Shenkangling decoction(ingredients:astragalus membranaceus,rehmannia glutinosa,cornus,yam,poria cocos,cortex moutan and pseudo-ginseng etc)on the basis of Group A.Enzyme linked immunosorbent assay(ELISA)was applied to detect the urine NGAL and urine L-FABP levels of Group A and Group B one and three months before and after treatment as well as that of Group C;at the same time,detected serum cystatain,al microspheres,serum creatinine and urine protein quantization,serum albumin and blood fat(cholesterol,triglyceride)of Group A and Group B and observed the changes of detection indexes before and after treatment.SPSS20.0 statistics software was applied to make statistics analysis of data.Results:1.The levels of urine NGAL and urine L-FABP in group A and B were significantly higher than those in group C(P<0.01),but there was no significant difference between group A and group B(P>0.05).There was no significant difference in ? 1-microglobulin,serum cystatin,serum creatinine,urinary protein,serum albumin,blood lipid(cholesterol,triglyceride)between group A and group B(P>0.05).2.After treatment for 1 month,The levels of urine NGAL,urine L-FABP,?1-microglobulin and urinary protein in group A and group B were significantly lower than those before treatment(P<0.01),urine L-FABP,urinary protein(Purine LFABP<0.05,P=<0.01).The levels of urinary NGAL in group A were significantly higher than those in group B(P<0.01),but there was no significant difference between group A and group B(P>0.05).The serum lipid in group A was lower than that before treatment(Pcholestero<0.01,Ptriglyceride<0.05),and there was no significant difference between group B and group B(P>0.05);group A and B were lower than those in group B(P<0.05)Cystatin and serum creatinine were not significantly different from those before treatment(P>0.05).There was no significant difference between group A and group B(P>0.05).The levels of serum albumin in group A and B were significantly higher than those in group A and B(P<0.01),group A was higher than group B(P<0.05).3.After 3 months of treatment,urine NGAL,urine L-FABP,al microglobulin,urinary protein,blood lipid were significantly lower than those before treatment(PB-triglyceride<O.05,the remaining P<0.01).There was no significant difference in serum cystatin and serum creatinine between group A and group B(P>0.05),serum albumin was significantly higher in group A and B(P<0.01).There was no significant difference(P>0.05)between group B and group B(P<0.01),and there was no significant difference between group B and group B(P<0.01).There was no significant difference in serum cystatin and serum creatinine between A and B(P>0.05).The levels of ?1-microglobulin,urinary protein,blood lipid in group A and B were decreased(P<0.05);A and B were significantly higher in serum albumin(P<0.01);There was no significant difference in NGAL,L-FABP,al-microglobulin,serum cystatin and serum creatinine between group A and group B(P>0.05),the levels of urinary protein,blood lipid in group A were lower than those in group B(P triglyceride<0.01,the remaining P<0.05),serum albumin levels in group A were higher than those in group B(P<0.05).Conclusions:Urine NGAL and urine L-FABP levels of pediatric PNS had abnormal increasing,which indicated that NGAL and L-FABP have participated in pathogenesis of PNS.As related factors of urinary protein participating in mechanism of renal tubular injury,NGAL and L-FABP preferentially reflect the tubular injury than serum cystatin and serum creatinine,which can be taken as early damage biomarker.Treating pediatric PNS with traditional Chinese medicine Shenkangling granule can decrease L-FABP levels significantly at 1 month after treatment,decrease abnormally increased urine protein,blood fat and elevated serum albumin,and then improve the illness of patients,which may relate to playing integral action when participating urine protein and renal tubular injury mechanism.