儿童腹型过敏性紫癜急性期血浆MPO、MDA和SOD的水平及临床意义-现代医学

儿童腹型过敏性紫癜急性期血浆MPO、MDA和SOD的水平及临床意义

单位：1. 江苏省南通市通州区人民医院儿科, 江苏南通 226000;
2. 江苏省南通大学附属医院急诊儿科, 江苏南通 226000;
3. 江苏省南通市通州区人民医院检验科, 江苏南通 226000

分类号：R725.9

出版年·卷·期（页码）：2017·36·第八期（1122-1126）

摘要：

目的：探索儿童腹型过敏性紫癜（HSP）患儿急性期血浆中氧化应激指标的水平及其与实验室指标的相关性。方法：以2012年11月到2016年11月因腹型过敏性紫癜急性期住院患儿70例为研究对象，并按照是否有蛋白尿分为单纯性腹型HSP组和肾脏受累HSP （HSPN）组。同期50例健康儿童为对照组。采集患儿和健康对照组血样并分析血浆中氧化应激标记物髓过氧化物酶（MPO）、丙二醛（MDA）和超氧化物歧化酶（SOD）的含量与IgA和患儿24小时尿蛋白含量，并分析血浆氧化应激因子与反映疾病进展的免疫球蛋白和反映肾损伤的尿蛋白含量的相关性。结果：与健康对照组相比，HSP组和HSPN组的血浆氧化应激指标均显著升高，IgA也显著高于对照组。与HSP组相比，HSPN组血浆氧化应激标志物和IgA又有进一步显著升高。且HSP组中，MPO、MDA和SOD均与IgA含量呈显著相关，HSPN组中MPO和MDA与IgA水平显著相关。HSP组中MPO和MDA及HSPN组中MPO与24小时尿蛋白显著相关。结论：急性期儿童腹型过敏性紫癜患儿中，血浆氧化应激水平显著升高，且与疾病严重程度显著相关，提示了氧化应激标记物作为评估过敏性紫癜患儿病情进展的临床价值。

Objective: To explore the changes of plasma oxidative stress parameters in children with acute abdominal Henoch-Schonlein purpura (HSP) and its clinical significance. Methods: 70 children diagnosed with HSP and admitted from November 2012 to November 2016 were recruited as subjects and allocatedinto pure abdominal HSP andHenoch-Schonlein purpura nephritis (HSPN) groups according to the presence or the absence of proteinuria. A total of 50 healthy children receiving physical examination were recruited as normal control. Blood samples were collected from HSP and HSPN groups as well as the healthy controls to evaluate the level of myeloperoxidase (MPO), malondialdehyde (MDA) and superoxide dismutase (SOD). Level of immunoglobulin A (IgA) and urine protein content collected within 24 hours were analyzed as well as the potential correlation between plasma oxidative stress parameters and immune complex IgA reflecting progress of HSP and 24-hour proteinuria reflecting renal injury. Results: Compared with the healthy controls, plasma oxidative stress parameters increased significantly in both HSP and HSPN groups, as well as significantly elevated IgA in plasma. Moreover, plasma oxidative stress parameters and IgA in HSPN group increased significantly higher than HSP group, indicating the higher severity of the disease. MPO, MDA and SOD levels in HSP group and MPO and MDA levels in HSPN group were significantly correlated with plasma IgA. Similarly, MPO and MDA in HSP group and MPO in HSPN group were significantly correlated with 24-hour proteinuria. Conclusion: Among thechildren with acute abdominal type HSP, theincrease of plasma oxidative stress parameters has been noticed, which is related with the severity of HSP. Results suggest that plasma oxidative stress parameters can be considered as indicators of clinical significance for progressing of HSP.

参考文献：

[1] 李惠丽.小儿过敏性紫癜的临床诊断及治疗探析[J].中国医药指南,2014(18):254-255.
[2] 罗苇,冯仕品,王莉,等.蛋白尿表现的儿童紫癜性肾炎临床与病理分析[J].临床儿科杂志,2014,32(2):156-159.
[3] 谢志玉,邱光钰.肠粘膜屏障功能与儿童过敏性紫癜的相关性分析[J].中国实验诊断学,2015(8):1396-1397.
[4] KESKIN N,CIVILIBAL M,ELEVLI M,et al.Elevated plasma advanced oxidation protein products in children with Henoch-Schonlein purpura.[J].Pediatric Nephrology,2011,26(11):1989-93.
[5] OZEN S,PISTORIO A,IUSAN S M,et al.EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura,childhood polyarteritis nodosa,childhood Wegener granulomatosis and childhood Takayasu arteritis:Ankara 2008.Part I:Overall methodology and clinical characterisation[J].Ann Rheum Dis,2010,69(5):798-806.
[6] 黄松明,李秋,郭艳芳.紫癜性肾炎的诊治:《儿童常见肾脏疾病诊治循证指南(试行)》解读(二)[J].中华儿科杂志,2009,47(12):914-916.
[7] 易著文.小儿过敏性紫癜的诊断与治疗[J].中国实用儿科杂志,2009(11):827-830.
[8] 张硕.小儿过敏性紫癜的诊断与治疗[J].中国医药指南,2016,14(16):157-158.
[9] GÜLLÜLÜ,DALK1L1Ç E,KARAKOÇ Y,et al.Henoch Schonlein Purpura-IgA nephritis-associated with anti phospholipid syndrome[C]//Ivth Congress of Balkan Cities Association of Nephrology,Dialysis,Transplantation and Artificial Organs,November.1999.
[10] DONADIO M E,LOIACONO E,PERUZZI L,et al.Toll-like receptors,immunoproteasome and regulatory T cells in children with Henoch-Schonlein purpura and primary IgA nephropathy[J].Pediatr Nephrol,2014,29(9):1545-1551.
[11] 魏雪旭.儿童过敏性紫癜腹型肠道粘膜损害的临床研究[D].河北医科大学,2015.
[12] 李玉飞,鹿玲.过敏性紫癜患儿血浆髓过氧化物酶、丙二醛、超氧化物歧化酶及总抗氧化能力水平变化[J].临床儿科杂志,2015,33(4):357-360.
[13] ECE A,KELEKCI S,HEKIMOGLU A,et al..Neutrophil activation,protein oxidation and ceruloplasmin levels in children with henoch-schönlein purpura[J].Pediatr Nephrol,2007,22(8),1151-1157.
[14] LSHIDA,H.Henoch-schönlein purpura accompanied with myeloperoxidase-antineutrophil cytoplasmic antibody (mpo-anca) associated vasculitis with elevated serum interleukin-10[J].Nihon Naika Gakkai Zasshi J Jap Soc Int Med,2005,94(8),1615-1617.
[15] COLLETER L,CORCOS O,VILGRAIN V,et al.Henoch-Schonlein purpura in adults[J].Diagnostic and Interventional Imaging.2014,95(6):637-640.
[16] POHL M.Henoch-Schönlein purpura nephritis[J].Pediatr Nephrol,2015,30(2):245-52.
[17] 钟燕兰,党西强,何小解,等.31例尿常规正常的过敏性紫癜肾脏病理改变[J].中国医师杂志,2012,14(3):322-324.

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