Clinical significance of the serum to urinary thioredoxin ratio for diagnosis and prediction of the severe acute pyelonephritisin children / 中国医师进修杂志

ABSTRACT

Objective@#To investigate the diagnostic and predictable value of the levels of serum Trx (S-Trx), urinary Trx (U-Trx) and S-Trx/U-Trx ratio in acute pyelonephritis of children.@*Methods@#A total of 120 children with urinary tract infection were divided into APN group (67 cases) and non-APN group (53 cases).In addition, 67 children with APN were assigned to severe group (23 cases)and non-severe group (44 cases). The leves of serum C-reactive protein(CRP), precalcitonin(PCT), cystatin C (CysC), Trx (S-Trx) and urinary β2-microglobulin(β2-MG), neutrophill gelatinase-related apolipoprotein (NGAL), Trx (U-Trx) were collected. Besides, the ratio of S-Trx/U-Trx was also counted. The diagnostic and predictable value of each index were determined by receiver operating characteristic (ROC).@*Results@#Serum PCT, S-Trx, urinary β2-MG, NGAL, U-Trx was markedly increased and S-Trx/U-Trx ratio was obviously decreased in the APN group compared to that of the non-APN group (P<0.05). Moreover, S-Trx, urinary NGAL, U-Trx was significantly increased and S-Trx/U-Trx ratio was significantly decreased in the severe group compared to that of the non-severe group (P<0.05). Both in APN group or severe APN group, S-Trx and U-Trx displayed significantly positive correlation (P<0.05). The results from ROC demonstrated that AUC were 0.960, and optimal cut-off value were 16.17 μg/L of U-Trx diagnostic APN in children, with a specificity and sensitivity of 94.34% and 92.54%, respectively. The optimal cut-off value was 1.29.AUC of S-Trx/U-Trx 0.960 predicted the severe of APN in children, with a specificity and sensitivity of 81.82% and 82.61%, respectively.@*Conclusions@#U-Trx is useful for diagnostic APN in children, S-Trx/U-Trx is an independent predictor of the severe APN.