标题：过敏性紫癜肾炎患儿血清 IL-16、IL-18、IGF-1及 IGFBP-3水平变化及临床意义

      作者：秦艳妮 1，党清华 1，景芳丽 1，王?敏 2    1.西安市中心医院儿科，陕西 西安 710061；2.西安市天佑医院儿科，陕西 西安 710061

      卷次： 2020年31卷1期

      【摘要】 目的 探究过敏性紫癜肾炎患儿血清白细胞介素-16 (IL-16)、白细胞介素-18 (IL-18)、胰岛素一号增长因子(IGF-1)及胰岛素样生长因子结合蛋白-3 (IGFBP-3)水平变化及临床意义。方法 选取2016年1月至2019年1月西安市中心医院儿科收治的过敏性紫癜患儿(HSP组) 38例及过敏性紫癜性肾炎患儿(HSPN组) 46例作为研究对象，以同期在我院体检的40例健康儿童作为对照组。其中HSPN组患儿按照国际儿童肾病学会病理分级标准分为Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级4个亚组。比较各大组受检者的血清 IL-16、IL-18、IGF-1及 IGFBP-3水平，并分析肾炎患儿 IL-16、IL-18、IGF-1、IGFBP-3水平与病理分级的相关性。结果 HSPN组患儿的血清 IL-16、IL-18、IGF-1、IGFBP-3水平分别为(134.22±26.82) ng/L、(263.5±36.15) ng/L、(0.95±0.51) ng/L、(0.86±0.50) ng/L，明显高于HSP组的(106.63±18.19) ng/L、(190.4±32.92) ng/L、(0.64±0.49) ng/L、(0.62±0.38) ng/L，而HSP组患儿的血清 IL-16、IL-18、IGF-1、IGFBP-3水平明显高于对照组的(64.85±13.38) ng/L、(102.3±25.34) ng/L、(0.31±0.19) ng/L、(0.43±0.23) ng/L，差异均有统计学意义(P<0.05)；肾炎Ⅳ级、Ⅲ级、Ⅱ级、Ⅰ级患儿血清 IL-16、IL-18、IGF-1、IGFBP-3水平分别为(154.22±26.82) ng/L、(279.5±10.28) ng/L、(1.31±0.26) ng/L、(1.47±0.36) ng/L；(117.27±8.20) ng/L、(210.45±10.92) ng/L、(0.98±0.12) ng/L、(0.87±0.24) ng/L；(92.14±6.54) ng/L、(160.46±8.49) ng/L、(0.84±0.17) ng/L、(0.69±0.23) ng/L；(67.36±4.38) ng/L、(105.34±6.33) ng/L、(0.39±0.02) ng/L、(0.48±0.05) ng/L，且肾炎Ⅳ级患者 IL-16、IL-18、IGF-1、IGFBP-3水平明显高于肾炎Ⅲ级，肾炎Ⅲ级明显高于肾炎Ⅱ级，肾炎Ⅱ级明显高于肾炎Ⅰ级，差异均有统计学意义(P<0.05)；相关性分析结果显示，肾炎患儿血清 IL-16、IL-18、IGF-1、IGFBP-3水平与病理分级呈正相关(r=0.946,、0.949、0.833、0.804，P<0.05)。结论 HSPN患儿血清 IL-16、IL-18、IGF-1及 IGFBP-3水平均上升，并随着肾脏损伤程度的加重呈上升趋势，可作为预测早期HSPN的参考指标。
      【关键词】 过敏性紫癜；肾炎；白细胞介素；胰岛素一号增长因子；胰岛素样生长因子结合蛋白-3
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2020）01—0031—04

Changes of serum IL-16, IL-18, IGF-1, and IGFBP-3 levels in children with Henoch-Sch?nleinpurpura nephritis and their clinical significance.
QIN Yan-ni 1, DANG Qing-hua 1, JING Fang-li 1,WANG Yan-min 2. 1. Department of Pediatrics, the Central Hospital of Xi'an City, Xi'an 710061, Shaanxi, CHINA; 2.Department of Pediatrics, the Tianyou Hospital of Xi'an City, Xi'an 710061, Shaanxi, CHINA
【Abstract】 Objective To investigate the changes and clinical significance of serum IL-16, IL-18, IGF-1, andIGFBP-3 levels in children with Henoch-Sch?nlein purpura (HSP) nephritis (HSPN). Methods From January 2016 toJanuary 2019, 38 children with Henoch-Schonlein purpura (HSP group) and 46 children with Henoch-Schonlein purpuranephritis (HSPN group) who admitted to Department of Pediatrics, the Central Hospital of Xi'an City, were selected asthe study subjects, and 40 healthy children who underwent physical examination in the same hospital during the same pe-riod were selected as the control group. The HSPN group was divided into four subgroups according to the pathologicalgrading criteria of the International Pediatric Nephrology Association (IPNA): grade Ⅰ, grade Ⅱ, grade Ⅲ and gradeⅣ. The serum levels of interleukin-16 (IL-16), interleukin-18 (IL-18), insulin-like growth factor I (IGF-1) and insu-lin-like growth factor binding protein-3 (IGFBP-3) were compared in each group, and the correlation between the levels ofIL-16, IL-18, IGF-1, and IGFBP-3 and pathological types was analyzed. Results The levels of IL-16, IL-18, IGF-1,and IGFBP-3 in the HSPN group were (134.22±26.82) ng/L, (263.5±36.15) ng/L, (0.95±0.51) ng/L, (0.86±0.50) ng/L, re-spectively, which were significantly higher than corresponding (106.63±18.19) ng/L, (190.4±32.92) ng/L, (0.64±0.49) ng/L,(0.62±0.38) ng/L in the HSP group (all P<0.05); the levels of IL-16, IL-18, IGF-1, and IGFBP-3 in the HSP group werealso significantly higher than corresponding (64.85±13.38) ng/L, (102.3±25.34) ng/L, (0.31±0.19) ng/L, (0.43±0.23) ng/Lin the control group (all P<0.05). There were significant differences in the IL-16, IL-18, IGF-1, IGFBP-3 levels amongthe children with nephritis gradeⅣ,Ⅲ,Ⅱ, gradeⅠ: (154.22±26.82) ng/L, (279.5±10.28) ng/L, (1.31±0.26) ng/L, (1.47±0.36) ng/L; (117.27±8.20) ng/L, (210.45±10.92) ng/L, (0.98±0.12) ng/L, (0.87±0.24) ng/L; (92.14±6.54) ng/L, (160.46±8.49) ng/L, (0.84±0.17) ng/L, (0.69±0.23) ng/L; (67.36±4.38) ng/L, (105.34±6.33) ng/L, (0.39±0.02) ng/L, (0.48±0.05) ng/L;all P<0.05. The results of correlation analysis showed that the levels of IL-16, IL-18, IGF-1 and IGFBP-3 in chil