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Objective • To evaluate the changes of urinary angiotensinogen (UAGT), fibroblast-specific protein-1 (FSP-1) and thrombin in the children with Henoch-Schonlein purpura nephritis (HSPN). Methods • Fourteen children with HSPN (HSPN group), 28 children with Henoch-Schonlein purpura (HSP) but without renal injury (HSP group) and 23 children with normal urinalysis (control group) were included in the study. Ten HSPN children before treatment (untreated group), 9 HSPN children after glucocorticoid (GC) pulse therapy (GC group) and 8 HSPN children after GC and cyclophosphamide (CTX) double pulse therapy (GC+CTX group) were also selected in the study. Clinical information and fresh morning urine samples were collected from all the children. UAGT, FSP-1 and thrombin in urine were measured by kits. Urine creatinine (Ucr) was also measured for correction. Results • UAGT/ Ucr and FSP-1 in HSPN group were significantly higher than those in HSP group and control group (P0.05), but thrombin levels in HSPN group and HSP group were both significantly higher than that in control group (P<0.05). UAGT/Ucr in HSPN untreated group had no significant difference, compared with GC group, while it was significantly higher than that in GC+CTX group (P=0.000). FSP-1 in untreated group was significantly higher than that in GC group, but had no significant difference, compared with GC+CTX group. There was no significant difference in thrombin among the 3 HSPN groups. Conclusion • UAGT/Ucr, FSP-1 and thrombin all increase in the urine of HSPN children, and UAGT/Ucr and FSP-1 may reflect the treatment effect to some extent. [Key words]
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Objective To observe effects of tripterygium glycosides combined with Xiangdan injection in henoch schonlein purpura nephritis (HSPN)and influence of the clotting mechanism,providing reference for clinical diagnosis and treatment.Methods 76 cases of children with allergic purpura nephritis were randomly divided into control group(n=38)and observation group(n=38)according to the random number table.Control group was given Xiangdan injection treatment.Observation group was given Xiangdan injection treatment combined with tripterygium glycoside.12 weeks was considered as a course of treatment. Results After treatment,the total efficiency rate in treatment group(94.74%)was significantly higher than control group(68.42%),which was statistically different(P <0.05).Before treatment,prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APPT),platelet(PLT)levels were not significantly different between two groups;FIB and PLT levels in the control group were significantly lower than before treatment(P<0.05 ),PT and APPT had no statistically significant difference before and after treatment.After treatment in observation group,FIB and PLT levels were significantly lower than before treatment(P<0.05 ),PT level was significantly higher compared with before treatment(P<0.05 ),APTT level had no difference before and after treatment.After treatment,PT in treatment group was significantly higher than the control group(P<0.05 ),PLT in treatment group were significantly lower than the control group (P <0.05 ),FIB and APTT had no statistical difference.There was no adverse reaction in two groups after treatment.Conclusion Tripterygium glycosides combined with Xiangdan injection treatment for HSPN has significant effect,which affect the children clotting mechanism to improve the PT,FIB,PLT levels.It is safe and valuable in clinical research.
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Objective:To analyze the podocalyxin (PCX) expression in the kidney and the number of urinary podocytes in different pathological grades of Henoch-Sch(o)nlein purpura nephritis (HSPN),and to determine whether the number of urinary podocytes reflects the renal damage in HSPN.Methods:Fifty-six children diagnosed with HSPN in our hospital were enrolled in the study and classified into 4 groups by renal pathology:grade Ⅱ (Ⅱa+Ⅱb) (n=10),grade Ⅲ (Ⅲa+Ⅲb) (n=21),grade Ⅳ (n=16),and grade Ⅴ (n=9).Four kidney autopsy specimens without histomorphologic lesions and 8 urine samples from healthy children served as controls.With immunofluorescence assay,the PCX expression in 4 normal renal tissues and in the renal tissues of the 56 HSPN children was detected and quantitatively analyzed.Positive rate and the number of urinary podocytes were detected in the 8 healthy children and 56 HSPN children.Results:In the renal tissues of the normal control group and grade Ⅱ (Ⅱa+Ⅱb) HSPN group,the PCX expression was complete.The percentage of the PCX positive area out of the total glomerular area in the renal tissues of 2 groups had no significant difference (P＞0.05).In the renal tissues of grade Ⅲ (Ⅲa+Ⅲb),Ⅳ,and Ⅴ HSPN groups,the PCX expression showed various degrees of loss,decreasing in turn from grade Ⅱ (Ⅱa+Ⅱb),Ⅲ (Ⅲa+Ⅲb),Ⅳ to Ⅴ,with significant differences between each group (P＜0.01).For HSPN with grade Ⅲ (Ⅲa+Ⅲb) or higher,positive PCX expression was found in the urine,suggesting the presence of enough podocytes in the urine.The percentage of fluorescence positive area out of the total glomerular area of PCX in the renal tissues was negatively correlated with the total number of urinary podocytes (r=-0.637,P＜0.01).Conclusion:Podocyte injury plays a certain role in the pathological progression of HSPN.The urinary detection ofpodocytes can reflect the degrees of pathological damage in HSPN.