Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (12): 74-79.doi: 10.6040/j.issn.1671-7554.0.2019.526

Previous Articles    

Correlation between urinary α1-antitrypsin and transferrin levels and hormone therapy effect on childrens primary nephrotic syndrome

PAN Yanyan1, SUN Yongchao2, LIU Xuemei1, ZHANG Hongxia1, ZHOU Weiran1, ZHAO Cuifen3   

  1. 1. Department of Pediatrics, Qilu Childrens Hospital of Shandong University, Jinan 250022, Shandong, China;
    2. Nursing Faculty, Jinan Vocational College of Nursing, Jinan 250203, Shandong, China;
    3. Department of Pediatrics, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-09-27

PDF (PC)

30

Abstract: Objective To investigate the value of urinary α1-antitrypsin(AAT)and transferrin(TRF)levels in predicting the clinical efficacy of hormone therapy on children with primary nephrotic syndrome(PNS). Methods A total of 90 PNS children hospitalized in Qilu Childrens Hospital of Shandong University from May 2016 to June 2017 were studied. According to the response of glucocorticoid treatment for 4 weeks, they were divided into hormone-sensitive group (n=60)and steroid-resistant group(n=30). At the same time, 30 healthy children were selected as normal control group. Fresh morning urine(20 mL)was collected and centrifugated at 4 ℃, then supernatant was acquired. The basic information and biochemical index levels of theserum cholesterol, serum creatinine, albumin and 24 h urinary protein measured before and after hormone therapy were collected. Enzyme linked immunosorbent assay(ELISA)was used to determine the concentrations of AAT and TRF levels in urine, and the correction value by urinary creatinine(Cr) 山 东 大 学 学 报 (医 学 版)57卷12期 -潘艳艳,等.尿液α1-抗胰蛋白酶、尿转铁蛋白水平与小儿原发性肾病综合征激素治疗效果的关联分析 \=-was used to predict the response of PNS children to hormone therapy. Results Compared with normal control group, the ratios of urinary AAT/Cr and TRF/Cr in steroid-sensitive group and steroid-resistant group were higher(P<0.05). The urinary AAT/Cr ratio and TRF/Cr ratio were statistically different between steroid-sensitive group and steroid-resistant group(P<0.05). The regression analysis showed that urinary AAT/Cr ratio and TRF/Cr ratio were risk factors for the clinical efficacy of steroid therapy on PNS children(P<0.05). Conclusion The concentrations of urinary AAT and TRF in steroid-resistant children after treatment are higher than those in steroid-sensitive children. If the urinary AAT and TRF levels increase in early stage of PNS, the children may be steroid- resistant.

Key words: Urine α1-antitrypsin, Urinary transferrin, Childrens primary nephrotic syndrome, Hormone resistance, Clinical efficacy

CLC Number: 

  • R543.2
[1] 王丽君, 李建国. 儿童激素耐药型肾病综合征的分子遗传学机制研究进展[J]. 中国妇幼保健, 2018, 33(11): 2621-2625. WANG Lijun, LI Jianguo. Advances in molecular genetic mechanisms of steroid-resistant nephrotic syndrome in children[J]. China Maternal and Child Health Care, 2018, 33(11): 2621-2625.
[2] 中华医学会儿科学分会肾脏病学组. 儿童常见肾脏疾病诊治循证指南(试行)(三):激素耐药型肾病综合征诊治指南[J].中华儿科杂志, 2010, 48(1): 72-75. The Subspecialty Group of Nephrology, Society of Pediatrics, Chinese Medical Association. Evidence-based guidelines on diagnosis and treatment of childhood common renal diseases(Ⅲ): guideline on diagnosis and treatment of steroid-resistant nephrotic syndrome[J].Chinese Journal of Pediatrics, 2010, 48(1): 72-75.
[3] 黄付甲, 侯鸿雁. 小儿原发性肾病综合征患者血浆蛋白Z、凝血因子Ⅷ活性的检验分析[J]. 国际检验医学杂志, 2018, 39(7): 815-817. HUANG Fujia, HOU Hongyan. Pediatric primary nephrotic syndrome patients comprehensive detection of plasma protein Z and coagulation factor Ⅷ activity analysis[J]. International Journal of Laboratory Medicine, 2018, 39(7): 815-817.
[4] 王荧荧. 预测儿童原发性肾病综合征激素疗效的尿液标志物研究[D]. 南京:南京医科大学, 2012.
[5] 中华医学会儿科学分会肾脏病学组.儿童常见肾脏疾病诊治循证指南(一):激素敏感、复发/依赖肾病综合征诊治循证指南(试行)[J]. 中华儿科杂志, 2009, 47(3): 167-170. The Subspecialty Group of Nephrology, Society of Pediatrics, Chinese Medical Association. Evidence-based guidelines on diagnosis and treatment of childhood common renal diseases(Ⅰ)Evidence-bused guideline on diagnosis and treatment of steroid-sensitive, relapsing/steroid-dependent nephrotic syndrome(for trial implementation)[J].Chinese Journal of Pediatrics, 2009, 47(3): 167-170.
[6] Zampini L, Padella L, Marchesiello RL, et al. Importance of the combined urinary procedure for the diagnosis of Mucopolysaccharidoses[J]. Clinica Chimica Acta, 2017, 464:165-169. doi: 10.1016/j.cca.2016.11.024.
[7] Rachmiel M, Strauss P, Dror N, et al. Alpha-1 antitrypsin therapy is safe and well tolerated in children and adolescents with recent onset type 1 diabetes mellitus[J]. Pediatr Diabetes, 2016, 17(5): 351-359.
[8] Behrman RE. Nelson textbook of pediatrics. 16th [M]. Phila-dephia: WB Sauders Company, 2000: 1500-1502.
[9] Machado JR, Rocha LP, Neves PD, et al. An overview of molecular mechanism of nephrotic syndrome[J]. Int J Nephrol, 2012, 2012:937623. doi: 10.1155/2012/937623.
[10] Kosuga M, Mashima R, Hirakiyama A, et al. Molecular diagnosis of 65 families with mucopolysaccharidosis type II(Hunter syndrome)characterized by 16 novel mutations in the IDS gene: genetic, pathological, and structural studies on iduronate-2-sulfatase [J]. Mol Genet Metab, 2016, 118(3): 190-197.
[11] Subspecialty Group Of Nephrology, The Society Of Pediatrics Chinese Medical Association. [Multicenter study on present status of diagnosis and treatment of steroid-resistant nephrotic syndrome in children] [J]. Zhonghua Er Ke Za Zhi, 2014, 52(7): 483-487.
[12] 王骞, 龚学忠. 急性肾损伤早期生物标志物研究及诊治进展[J]. 世界中西医结合杂志, 2014, 9(1): 105-108.
[13] 聂静涛. 防己黄芪汤对原发性肾病综合征水肿期患者的疗效及对24 h尿蛋白、血清白蛋白、血脂的影响[J]. 实用临床医药杂志, 2017, 21(1): 48-51. NIE Jingtao. Effect of Fangji Huangqi decoction on edema of primary nephrotic syndrome and its effect on 24 h urinary protein, serum albumin and lipid [J]. Journal of Practical Clinical Medicine, 2017, 21(1): 48-51.
[14] Franciosi AN, McCarthy C, McElvaney NG. The efficacy and safety of inhaled human α-1 antitrypsin in people with α-1 antitrypsin deficiency-related emphysema[J]. Expert Rev Respir Med, 2015, 9(2):143-151.
[15] 苑晓舟, 孟岩, 梁爽, 等. 黏多糖病患者尿液α1-抗胰蛋白酶含量的研究[J]. 生命科学仪器, 2016, 14(12): 47-51. YUAN Xiaozhou, MENG Yan, LIANG Shuang, et al. Study on the content of α1-antitrypsin in mucopolysaccharidosis patients [J]. Life Science Instrument, 2016, 14(12): 47-51.
[16] Chen C, Luo M, Ye T, et al. Sensitive colorimetric detection of protein by gold nanoparticles and rolling circle amplification[J]. Analyst, 2015, 140(13): 4515-4520.
[17] 张鑫, 赵蕴芝, 许文娟. 尿免疫球蛋白、转铁蛋白、微量白蛋白及β2 -微球蛋白的联合检测对妊娠期高血压疾病的临床价值[J]. 海军医学杂志, 2015, 36(6): 511-513. ZAHNG Xin, ZHAO Yunzhi, XU Wenjuan. Clinical value of combined detection of urinary immunoglobulin, transferrin, microalbumin and β2-microglobulin in hypertensive disorder complicating pregnancy [J]. Journal of Naval Medicine, 2015, 36(6): 511-513.
[18] 胡顺金, 汪飞, 胡亚文, 等. 中医药分阶段论治对糖皮质激素治疗原发性肾病综合征疗效的系统评价[J]. 中华中医药杂志, 2014, 29(2): 395-398. HU Shunjin, WANG Fei, HU Yawen, et al. Systematic evaluation of the therapeutic effect of glucocorticoid on primary nephrotic syndrome by stages of traditional Chinese medicine [J]. Chinese Journal of Traditional Chinese Medicine, 2014, 29(2): 395-398.
[19] Graterol F, Navarro-Muñoz M, Ibernon M, et al. Poor histological lesions in IgA nephropathy may be reflected in blood and urine peptide profiling[J]. BMC Nephrol, 2013, 14(1): 82. doi: 10.1186/1471-2369-14-82.
[20] 张晓丹, 叶剑, 廖玉婷,等.人α1-抗胰蛋白酶在胰岛β细胞移植中免疫抑制和保护作用的研究[J]. 中国病理生理杂志, 2013, 29(4): 619-625.
[21] Strandhave C, Svensson M, Krarup H, et al. Haptoglobin genotype and risk markers of cardiovascular disease in patients with chronic kidney disease[J]. Int J Nephrol, 2013, 2013: 650847. doi: 10.1155/2013/650847.
[22] 杨俊. 检测尿转铁蛋白对诊断早期妊娠高血压综合征并发肾损害的价值[J]. 检验医学与临床, 2014, 11(21): 3038-3040. YANG Jun. The value of urinary transferrin in the diagnosis of renal damage in early pregnancy induced hypertension syndrome [J]. Laboratory Medicine and Clinical, 2014, 11(21): 3038-3040.
[23] 周健, 张茂, 刘德云, 等. 尿微量白蛋白与尿肌酐比值及尿NAG检测在肾结石微创手术中的应用价值[J]. 标记免疫分析与临床, 2016, 23(4): 379-381. ZHOU Jian, ZHANG Mao, LIU Deyun, et al. The value of urinary microalbumin/creatinine ratio and urinary NAG in minimally invasive surgery for renal calculi [J]. Marker Immunoassay and Clinical, 2016, 23(4): 379-381.
[24] Bhensdadia NM, Hunt KJ, Lopes-Virella MF, et al. Urine haptoglobin levels predict early renal functional decline in patients with type 2 diabetes[J]. Kidney Int, 2013, 83(6): 1136-1143.
[25] Lipska BS, Iatropoulos P, Maranta R, et al. Genetic screening in adolescents with steroid-resistant nephrotic syndrome[J]. Kidney Int, 2013, 84(1): 206-213.
[1] WEI Mingyong, REN Huiling, WU Jun, PENG Xue, XIE Wenfu, ZHANG Min. Clinical efficacy of endoscopic resection of small colorectal polyps with thermal biopsy forceps [J]. Journal of Shandong University (Health Sciences), 2018, 56(6): 47-50.
[2] GENG Erdong, NING Juan. Efficacy of atenolol on the treatment of acute coronary syndrome complicated with arrhythmia and the prognosis [J]. Journal of Shandong University (Health Sciences), 2018, 56(5): 70-73.
[3] PAN Shiyang. Research advances in markers for the evaluation of lung cancer efficacy [J]. Journal of Shandong University (Health Sciences), 2018, 56(10): 31-39.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd