小儿原发性肾病综合征血浆可溶性血栓调节蛋白、超敏C反应蛋白检测的临床意义
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摘要
目的探讨小儿原发性肾病综合征(PNSC)血浆可溶性血栓调节蛋白(sTM)、超敏C反应蛋白(hs-CRP)水平与高凝状态的关系。方法选取2016年2月—2017年10月通许县人民医院诊治的103例PNSC患儿为观察组,另选取同期在医院进行健康体检的儿童志愿者60例为对照组。检测两组血浆sTM、hs-CRP水平,分析患儿血浆sTM、hs-CRP水平与高凝状态的相关性。结果观察组血浆sTM、hs-CRP水平均高于对照组,差异有统计学意义(P<0.05),尿蛋白转阴后血浆sTM、hs-CRP、24 h尿蛋白定量(24 hUpro)、载脂蛋白B(APOB)及纤维蛋白原(FIB)水平均低于治疗前,而血浆清蛋白(ALB)水平高于治疗前,差异有统计学意义(P<0.05)。根据Spearman法分析相关性可知,患儿血浆sTM、hs-CRP水平与24 hUpro、APOB及FIB均呈正相关,与ALB均呈负相关。结论 PNSC患儿血浆sTM、hs-CRP水平处于较高状态,且二者与24 hUpro、APOB及FIB呈正相关,与ALB呈负相关。临床上可通过监测二者的水平而科学、全面地评估患儿病情。
Objective To study the relationship between plasma sTM,hs-CRP level and hypercoagulability of PNSC. Methods 103 children with PNSC from February,2016 to October,2017 were selected as the observation group. Another 60 children who underwent health examination in the hospital in the same period were selected as the control group. The plasma level of sTM and hsCRP was measured and compared between the two groups. The correlation between plasma sTM,hs-CRP and hypercoagulability was analyzed. Results The plasma level of sTM and hs-CRP in the observation group was higher than the control group,and there was statistically significant difference(P<0.05). After the proteinuria turned negative in the observation group,the level of plasma 24 h Upro,APOB,FIB,sTM and hs-CRP was lower than before treatment. The level of plasma ALB was higher than before treatment(P<0.05). According to the correlation of Spearman analysis,the plasma level of sTM and hs-CRP was positively correlated with 24 h Upro,APOB and FIB,and it was negatively correlated with ALB. Conclusion The plasma level of sTM,hs-CRP in children with PNSC is higher,and the two factors have a positive correlation with 24 h Uprol,APOB and FIB,and have negative correlation with ALB. Clinical monitoring of both can be used to scientifically and comprehensively assess the state of children's illness.
Objective To study the relationship between plasma sTM,hs-CRP level and hypercoagulability of PNSC. Methods 103 children with PNSC from February,2016 to October,2017 were selected as the observation group. Another 60 children who underwent health examination in the hospital in the same period were selected as the control group. The plasma level of sTM and hsCRP was measured and compared between the two groups. The correlation between plasma sTM,hs-CRP and hypercoagulability was analyzed. Results The plasma level of sTM and hs-CRP in the observation group was higher than the control group,and there was statistically significant difference(P<0.05). After the proteinuria turned negative in the observation group,the level of plasma 24 h Upro,APOB,FIB,sTM and hs-CRP was lower than before treatment. The level of plasma ALB was higher than before treatment(P<0.05). According to the correlation of Spearman analysis,the plasma level of sTM and hs-CRP was positively correlated with 24 h Upro,APOB and FIB,and it was negatively correlated with ALB. Conclusion The plasma level of sTM,hs-CRP in children with PNSC is higher,and the two factors have a positive correlation with 24 h Uprol,APOB and FIB,and have negative correlation with ALB. Clinical monitoring of both can be used to scientifically and comprehensively assess the state of children's illness.
引文
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[5]郑志方,陈国利,郭春艳,等.承德地区原发性肾病综合征儿童临床特点及C反应蛋白水平分析[J].中国煤炭工业医学杂志,2017,20(2):125-128.
[6]张宏文,肖慧捷,姚勇,等.他克莫司治疗小儿肾病综合征致急性肾衰竭3例报告[J].临床儿科杂志,2017,35(6):409-411.
[7]郑志方,陈国利,敬小青,等.降钙素原、C-反应蛋白和白细胞计数联合检测在儿童原发性肾病综合征合并细菌感染中的分析价值[J].中国妇幼保健,2017,32(18):4445-4447.
[8]张碹,张碧丽,王文红,等.血栓调节蛋白、超敏C反应蛋白与儿童原发性肾病综合征高凝状态的相关性[J].中华实用儿科临床杂志,2017,32(5):342-345.
[2]中华医学会儿科学分会肾脏学组.儿童激素敏感、复发/依赖肾病综合征诊治循证指南(2016)[J].中华儿科杂志,2017,55(10):729-734.
[3]黄赟,夏校敏,姚景春.肾综合征出血热患者凝血纤溶功能和可溶性血栓调节蛋白的变化[J].基层医学论坛,2015,19(19):2648-2649.
[4]胡梦倩.基于中医传承辅助系统的小儿原发性肾病综合征组方用药经验分析[D].济南:山东中医药大学,2017.
[5]郑志方,陈国利,郭春艳,等.承德地区原发性肾病综合征儿童临床特点及C反应蛋白水平分析[J].中国煤炭工业医学杂志,2017,20(2):125-128.
[6]张宏文,肖慧捷,姚勇,等.他克莫司治疗小儿肾病综合征致急性肾衰竭3例报告[J].临床儿科杂志,2017,35(6):409-411.
[7]郑志方,陈国利,敬小青,等.降钙素原、C-反应蛋白和白细胞计数联合检测在儿童原发性肾病综合征合并细菌感染中的分析价值[J].中国妇幼保健,2017,32(18):4445-4447.
[8]张碹,张碧丽,王文红,等.血栓调节蛋白、超敏C反应蛋白与儿童原发性肾病综合征高凝状态的相关性[J].中华实用儿科临床杂志,2017,32(5):342-345.