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目的探讨过敏性紫癜(HSP)患儿血清胰岛素样生长因子-Ⅰ(IGF-Ⅰ)和胰岛素样生长因子结合蛋白-3(IGFBP-3)水平的变化及其临床意义。方法选取2009年3月—2011年9月就诊于我院明确诊断为HSP的患儿44例,另选取同时期健康体检正常的儿童26例为对照组。检测两组的血清IGF-Ⅰ及IGFBP-3、白细胞计数(WBC)、血小板计数(PLT)、纤维蛋白原(FIB)、C反应蛋白(CRP)、红细胞沉降率(ESR)、补体(C3、C4)、免疫球蛋白(IgA、IgG及IgM)水平,尿常规、便常规,计算IgA/C3。结果 HSP组较对照组血清IGF-Ⅰ、IGFBP-3、WBC、PLT、FIB、CRP、ESR、C3、C4、IgA、IgG、IgM水平及IgA/C3均升高,差异有统计学意义(P<0.05)。伴蛋白尿组较不伴蛋白尿组HSP患儿血清IGF-Ⅰ、IGFBP-3水平均升高,CRP水平降低,差异有统计学意义(P<0.05)。伴血尿组较不伴血尿组HSP患儿血清IGF-Ⅰ、IGFBP-3、ESR水平及IgA/C3均升高,CRP水平降低,差异有统计学意义(P<0.05)。伴大便潜血阳性组较不伴大便潜血阳性组HSP患儿血清IGFBP-3、WBC、PLT、FIB、ESR、IgA、IgM水平及IgA/C3均升高,CRP水平降低,差异有统计学意义(P<0.05)。HSP患儿血清IGF-Ⅰ、IG-FBP-3水平与尿蛋白均呈正相关(r值分别为0.341和0.212,P<0.05)。结论 HSP患儿血清中IGF-Ⅰ和IGFBP-3水平升高,IGF-Ⅰ和IGFBP-3水平可能将作为HSP累及肾脏的新指标。
Objective To investigate the changes and clinical significance of serum insulin-like growth factor-I (IGF-Ⅰ) and insulin-like growth factor binding protein-3 (IGFBP-3) in children with Henoch-Schonlein purpura (HSP) Methods Forty-four children with HSP diagnosed in our hospital from March 2009 to September 2011 were selected. Twenty-six healthy children were selected as the control group. Serum levels of IGF-Ⅰ and IGFBP-3, WBC, PLT, FIB, CRP, ESR, C3, C4), immunoglobulin (IgA, IgG and IgM) levels, urine routine, then routine, calculate IgA / C3. Results The levels of serum IGF-Ⅰ, IGFBP-3, WBC, PLT, FIB, CRP, ESR, C3, C4, IgA, IgG, IgM and IgA / C3 in HSP group were significantly higher than those in control group <0.05). Serum levels of IGF-I and IGFBP-3 in HSP patients with proteinuria were lower than those in proteinuria group, while CRP level was lower (P <0.05). Serum levels of IGF-Ⅰ, IGFBP-3, ESR, IgA / C3 and CRP in children with and without hematuria were significantly lower than those without hematuria (P <0.05). The levels of serum IGFBP-3, WBC, PLT, FIB, ESR, IgA, IgM, IgA / C3 and IgA / C3 were all increased and the level of CRP was lower in HSP patients with fecal occult blood positive than those without positive fecal occult blood P <0.05). Serum levels of IGF-I and IG-FBP-3 in children with HSP were positively correlated with urine protein (r = 0.341 and 0.212, respectively, P <0.05). Conclusions The levels of IGF-Ⅰ and IGFBP-3 in serum of HSP patients are elevated, and the levels of IGF-Ⅰ and IGFBP-3 may be used as new indexes of HSP in renal involvement.