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目的:探讨血液、尿液单核细胞趋化蛋白-1(MCP-1)的含量变化与蛋白尿的关系及其在儿童IgA肾病中的作用。方法:根据24 h尿蛋白定量将2008年1月～2011年10月收治的33例IgA肾病儿童分为大量蛋白尿组(>1.5 g)22例和小量蛋白尿组(≤1.5 g)11例,另外选取同期健康儿童50例作为正常对照组。采用ELISA法测定所有儿童血液和尿液MCP-1,对MCP-1与24 h尿蛋白定量、血肌酐、血尿β2微球蛋白以及肾脏病理分级的相关性进行分析。结果:大量蛋白尿组、小量蛋白尿组和正常对照组尿液MCP-1含量分别为(138.8±58.5)pg/ml、(76.4±36.2)pg/ml、(22.6±12.1)pg/ml,血液MCP-1含量分别为(23.9±5.1)pg/ml、(19.6±4.2)pg/ml、(17.6±2.5)pg/ml,尿液MCP-1含量两两比较,差异均有统计学意义(P<0.05),血液MCP-1含量三组比较差异均无统计学意义(P>0.05)。结论:MCP-1可能在儿童IgA肾病的病理损害中发挥重要作用,尿液MCP-1可作为评价IgA肾病肾功能的一项辅助指标。
Objective: To investigate the relationship between changes of monocyte chemoattractant protein-1 (MCP-1) and proteinuria in blood and urine and its role in IgA nephropathy in children. Methods: Thirty-three children with IgA nephropathy admitted from January 2008 to October 2011 were divided into two groups according to 24 h urinary protein: 22 patients with large albuminuria (> 1.5 g) and small albuminuria (≤1.5 g) 11 Cases, another selection of 50 healthy children at the same period as a normal control group. The blood and urine MCP-1 levels in all children were determined by ELISA. The correlation between MCP-1 and 24 h urinary proteinuria, serum creatinine, hematuria and β2-microglobulin, and renal pathological grade were analyzed. Results: The urinary MCP-1 contents of large proteinuria group, small proteinuria group and normal control group were (138.8 ± 58.5) pg / ml, (76.4 ± 36.2) pg / ml, 22.6 ± 12.1 pg / ml (23.9 ± 5.1) pg / ml, (19.6 ± 4.2) pg / ml and (17.6 ± 2.5) pg / ml, respectively. The differences of MCP-1 in blood between the two groups were statistically significant Significance (P <0.05), blood MCP-1 content in three groups showed no significant difference (P> 0.05). CONCLUSION: MCP-1 may play an important role in the pathogenesis of IgA nephropathy in children. Urine MCP-1 may be used as a supplementary indicator to evaluate the renal function of IgA nephropathy.