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目的联合检测血清胱抑素C(CysC)与尿微量蛋白系列,探讨其在儿童过敏性紫癜(HSP)早期肾损害诊断中的临床价值。方法液相透射比浊法及免疫散射比浊法测定儿童HSP血清CysC及尿微量蛋白系列[转铁蛋白(TRF)、NAG/CR、IGGU/CR、ALBU/CR、α1MU/CR],检测尿常规和血尿素氮(BUN)、肌酐(Scr),其中NAG测定运用比色法、肌酐测定运用终点法,并与对照组比较。结果 HSP患儿血清胱抑素C、尿微量蛋白系列检测值明显高于对照组,差异均有显著性意义(P<0.01);血尿6项指标联合检测异常率为80.43%(37/46),尿常规异常率为23.91%(11/46),两者比较差异有显著性意义;35例尿常规正常者6项指标异常率达74.29%(26/35),且6项指标较两项指标异常发生率增高,差异均有统计学意义;血清CysC与尿微量蛋白系列呈正相关。结论尿常规阴性并不能排除肾的早期损伤,血尿6项指标联合检测是诊断HSP早期肾损伤的良好指标,且血清CysC灵敏度及特异度均优于尿微量蛋白,血尿6项指标联合检测可作为临床早期诊断肾损伤的可靠依据。
Objective To evaluate the clinical value of serum cystatin C (CysC) and microalbuminuria in the diagnosis of early renal damage in children with Henoch-Schonlein purpura (HSP). Methods The levels of serum CysC and urinary microalbuminuria (TRF), NAG / CR, IGGU / CR, ALBU / CR and α1MU / CR in children were detected by liquid chromatography and turbidimetry. Routine and blood urea nitrogen (BUN), creatinine (Scr), which NAG determination using colorimetric, creatinine determination by end-point method and compared with the control group. Results Serum levels of cystatin C and urine microalbumin in children with HSP were significantly higher than those in the control group (P <0.01). The abnormality rate of six markers in hematuria was 80.43% (37/46) , Urinary routine abnormalities rate was 23.91% (11/46), the difference between the two was significant; 35 cases of urine normal six indicators abnormal rate of 74.29% (26/35), and six indicators more than two The abnormal rate of the index increased, the differences were statistically significant; serum CysC and urinary microalbumin series was positively correlated. Conclusion Negative urinary routine test can not rule out the early renal injury. The combined detection of 6 indicators of hematuria is a good indicator for diagnosing HSP in early stage of kidney injury. The sensitivity and specificity of serum CysC are better than those of urinary microalbumin. Preclinical early diagnosis of renal injury and reliable basis.