摘要
目的检测原发性肾病综合征(primary nephrotic syndrome,PNS)患儿血清转化生长因子β1(transforminggrowth factorβ1,TGF-β1)、结缔组织生长因子(connective tissue growth factor,CTGF)、骨形态发生蛋白-7(bone mor-phogenetic protein-7,BMP-7)水平,探讨三者水平与治疗效应的关系。方法酶联免疫吸附试验(enzyme-linked immu-nosorbent assay,ELISA)方法,测定44例接受治疗的PNS患儿治疗前及缓解后血清TGF-β1、CTGF、BMP-7水平;并与20例对照组相比较。结果与对照组相比,26例激素敏感组治疗前TGF-β1显著升高(P<0.01),治疗后TGF-β1、治疗前及治疗后CTGF、BMP-7无统计学差异(P>0.05);18例激素耐药组治疗前后TGF-β1水平均升高(P<0.05),治疗前CTGF及BMP-7无统计学差异,治疗后CTGF显著升高(P<0.01),治疗后BMP-7显著降低(P<0.01)。与激素敏感组相比,激素耐药组治疗前TGF-β1、CTGF及BMP-7无统计学差异,治疗后TGF-β1及CTGF升高(P<0.05或P<0.01),BMP-7显著降低(P<0.01)。与治疗前相比,激素敏感组治疗后TGF-β1显著下降(P<0.01),CTGF及BMP-7无明显变化;激素耐药组治疗后CTGF显著升高(P<0.01),BMP-7显著降低(P<0.01)。18例激素耐药型患儿免疫抑制剂治疗治疗后10例病情完全缓解,8例未完全缓解,完全缓解组TGF-β1、CTGF水平较未完全缓解组下降(P<0.05),而BMP水平明显上升(P<0.01)。TGF-β1、CTGF、BMP-7、TGF-β1/BMP-7与尿蛋白定量无显著相关性(r=0.12、0.11、-0.24、0.13,P均>0.05)。CTGF/BMP-7与尿蛋白密切相关(r=0.54,P<0.05)。结论血清TGF-β1、CTGF及BMP-7水平可作为反映PNS病情、评价治疗效应的预测指标。
Objective To detect the level of serum transforming growth factor-β1（TGF-β1）,connective tissue growth factor（CTGF） and bone morphogenic protein-7（BMP-7） and explore the correlation between their levels and therapeutic effect in children with primary nephrotic syndrome（PNS）.Methods Serum TGF-β1,CTGF and BMP-7 levels were detected by double-antibody sandwich sensitive enzyme-linked immunosorbent assay（ELISA） in 44 children with PNS before treatment and after remission.Twenty normal children were as the normal control group（NC）.Results Compared with NC group,26 patients with sensitive response to prednisone had higher level of serum TGF-β1 before treatment（P0.01）,but no significantly different levels of TGF-β1 after treatment and CTGF,BMP-7 before and after treatment（P0.05）;18 steroid-resistant patients had higher TGF-β1 level before and after treatment（P0.05）,higher CTGF level（P0.01） and lower BMP-7 level after treatment（P0.01）,but no significantly different levels of CTGF and BMP-7 before treatment.Compared with steroid-sensitive children,the levels of TGF-β1,CTGF and BMP-7 in steroid-resistant children had no significant difference before treatment,but TGF-β1 and CTGF levels were higher and BMP-7 were lower after treatment（P0.05 or P0.01）.After treatment,in steroid-sensitive children,TGF-β1 level was significantly decreased（P0.01） and CTGF,BMP-7 had no significant changes;in steroid-resistant children,TGF-β1 and BMP-7 levels were significantly increased（P0.05 or P0.01） and CTGF had no significant changes（P0.05）.In 18 steroid-resistant children,10 had complete remission.After immunosuppressive agents treatment,their TGF-β1 and CTGF levels were higher and BMP-7 level was lowers lower than those of 8 patients without complete remission.There was no correlation between TGF-β1,CTGF,BMP-7,TGF-β1/BMP-7 levels and the proteinuria degree（r=0.12,0.11,-0.24,0.13,P0.05）.A unique correlation was found between CTGF/BMP-7 and the proteinuria degree（r=0.54,P0.05）.Conclusion The levels of serum TGF-β1,CTGF and BMP-7 might be predictive indicators in reflecting disease activity and evaluating the therapeutic effect in patients with PNS.
出处
《华南国防医学杂志》
CAS
2011年第3期202-205,共4页
Military Medical Journal of South China
