| Objective The study investigate the changes of ESM-1 and s ICAM-1 in the serum of the children with HSP and HSPN and the expression of ESM-1 in renal tissues of HSPN.To explore new indicators that can reflect HSP kidney involvement and provide theoretical basis.Methods 74 patients in the First Affiliated Hospital of Zhengzhou University between October 2015 and August 2016 were enrolled into this study as test group,including 32 cases with HSP(HSP group)and 42 cases with HSPN(HSPN group);Twenty one healthy children age-matched been chosen as control group.In the HSPN group,there were 30 cases with renal biopsy(RB patients),and 12 cases with conservative treatment.RB patients were divided into three subgroups,A group is grade II and below,n=8;B group is grade IIIa,n=14;C group is grade IIIb,n=8;8 MCD patients were served as renal tissues controls.The level of serum ESM-1 and s ICAM-1 were measured by ELISA,and the expression of ESM-1 in renal tissues was detected by immunohistochemistry.Data were analyzed using SPSS 21.0.Results 1.Three groups of serum ESM-1,s ICAM-1 levels The levels of ESM-1 and s ICAM-1 in HSP group and HSPN group were significantly higher than those in the control group,and HSPN group was higher than that in HSP group(all P <0.01).The difference of blood s ICAM-1 between HSPN group and non-proteinuria was statistically significant(Z =-2.575,P = 0.01),but there was no significant difference in blood ESM-1(t =-1.01,P = 0.318).There was no significant difference in ESM-1 and s ICAM-1 levels between the pathologic groups(?2= 0.298,P = 0.585;?2 = 1.892,P = 0.401).2.Expression of ESM-1 in glomeruli(AOD value)The expression of ESM-1(AOD)in the MCD group? group A?group B and group C were different(F= 10.09,P <0.01).Further comparison between the two groups found that C group AOD values were higher than the other groups,and the differences between them were statistically significant(all P <0.01).Howere,there were no significant differences in AOD between group A?group B?MCD group(all P> 0.05).3.ESM-1 and the relevance of the pathological level The expression of ESM-1 in renal tissue of RB patients was positively correlated with pathological grade(r = 0.617,P <0.01).Serum ESM-1 level was positively correlated with ESM-1 in renal tissue(r = 0.783,P <0.01).There was no correlation between serum ESM-1 level and renal pathological grade(r = 0.169,P = 0.371).4.ESM-1,s ICAM-1 and clinical indicators There was a positive correlation between serum ESM-1 and serum s ICAM-1(r = 0.894,P <0.01);The levels of ESM-1 and s ICAM-1 were negative correlated with D-dimer(r=-0.320,P=0.013;r =-0.291,P=0.024);The levels of ESM-1 and s ICAM-1 were positively correlated with urinary NAG(r=0.324,P=0.015;r =0.275,P =0.041).Conclusion 1.ESM-1 and s ICAM-1 may play the essential roles in the occurrence and development of HSP and HSPN.2.ESM-1 and s ICAM-1 could serve as the objective indicators of HSP involvement in the kidney.3.The monitoring the level of serum ESM-1 can indirectly refelect the expression of ESM-1 in the kidney. |
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