原发肾病综合征患儿超声颈动脉参数、血清sTREM-1、suPAR水平变化及与急性肾损伤的相关性

选取原发性肾病综合征(PNS)患儿96例作为研究组,选取同期96例健康体检儿童作为对照组,开展前瞻性队列研究,均行超声颈动脉参数、血清可溶性髓系细胞表达的触发受体-1(sTREM-1)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平检测,并进行对比分析。本研究发现,研究组患儿颈动脉内中膜厚度(cIMT)、平均管壁横截面积(WCSA)、血清sTREM-1和suPAR水平高于对照组,血管壁运动度(△D)低于对照组(P<0.05);PNS患儿TG、TC、尿NAG、β2-MG、24 h Upro与cIMT、WCSA、血清sTREM-1、suPAR水平间存在正相关关系,与△D间存在负相关关系(P<0.05);随着cIMT、WCSA、血清sTREM-1、suPAR水平升高及△D降低,PNS发病风险逐渐增加(P<0.05);cIMT、△D、WCSA、血清sTREM-1、suPAR联合预测PNS患儿急性肾损伤的曲线下面积(AUC)为0.914。据此可得PNS患儿超声颈动脉参数中cIMT、WCSA及血清sTREM-1、suPAR表达水平明显升高,△D异常降低,且均与患儿血脂升高、肾功能降低存在明显相关性,可辅助临床预测PNS患儿急性肾损伤风险。

Changes of Ultrasound Carotid Parameters,Serum sTREM-1,suPAR Levels and the Correlation with Acute Kidney Injury in Children with Primary Nephropathy Syndrome

In this research,96 children with primary nephrotic syndrome(PNS)in our hospital were selected as the research group,and 96 healthy children were randomly selected as the control group to conduct a prospective cohort study.The ultrasound carotid parameters were detected,as well as serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and soluble urokinase plasminogen activator receptor(suPAR)levels,on which comparative analysis was performed.It was found that the carotid intima-media thickness(cIMT),mean wall cross-sectional area(WCSA),serum sTREM-1 and suPAR levels of the study group were higher than those of the control group.And the degree of vascular wall motion(△D)was lower than that of the control group(P<0.05).There was a positive correlation between TG,TC,urine NAG,β2-MG,24 h Upro and cIMT,WCSA,serum sTREM-1,suPAR levels in children with PNS,and a negative correlation between TG,TC,urine NAG,β2-MG,24 h Upro and△D(P<0.05).With the increase of cIMT,WCSA,serum sTREM-1,suPAR levels and the decrease of△D,the risk of PNS gradually increased(P<0.05).The area under the curve(AUC)was 0.914,which combined cIMT,△D,WCSA,serum sTREM-1 and suPAR to predict acute kidney injury in children with PNS.Based on these results,it is suggested that the cIMT,WCSA and the expression levels of serum sTREM-1 and suPAR in children with PNS are significantly increased,and△D is abnormally decreased,which has a significant correlation with the increase of blood lipids and decreased renal function in children.