Objective To investigate the effects of insulin-like growth factor 1 (IGF 1) and transforming growth factor beta 1 (TGF-β1) in he pathogenesis of children with allergic purpura kidney damage.Methods 135 henoch-schonlein purpura (HSP) children with kidney damage were divided into HSP and HSPN group according to whether associated with renal damage,blood IGF 1,TGF-β1,urinary inhibition C (Cys C),creatinine (SCr) and content of urea nitrogen (BUN) were compared,and blood IGF-1,TGF-β1 and Cys C content of HSPN patients in different pathological grading were compared,the correlation of blood IGF 1,TGF-β1 and Cys C content of the HSPN group were analyzed,Results Blood IGF 1,TGF-β1 and Cys C content of the control group(117.2±18.8 ng/L,164.2±18.4 ng/L,0.9±0.2 mg/L),the HSP group(131.7±19.6 ng/L,282.1±28.3 ng/L,1.1±0.2 mg/L) and the HSPN group (205.3±24.5 ng/L,489.2±32.7 ng/L,1.3±0.3 mg/L) showed a trend of increasing gradually (F=4.824～45.066,P value＜0.01),the HSP group and the HSPN group were higher than that of the control group (q=3.397～58.931,P value＜0.01),the HSPN group was higher than that of the HSP group (q=16.997,35.193,P value＜0.01),the difference was statistically significant.Blood IGF-1 (level Ⅱ 175.6 ± 20.4 ng/L,level m198.5±23.3 ng/L,level Ⅳ241.7±25.1 ng/L),TGF-β1(level Ⅱ 392.8±38.9 ng/L,level Ⅲ 481.3± 44.03 ng/L,level Ⅳ 537.6±42.9 ng/L),Cys C (level 11 1.1±0.3 mg/L,level Ⅲ 1.3±0.4 mg/L,level Ⅳ1.6±0.4 mg/L) content of children with HSPN increased with the increase of renal pathology classification (F=6.594～ 28.317,P value ＜0.01),blood IGF-1,TGF-β1 and Cys C content of kidney pathology classification of Ⅵ level in children was higher than that of the level of Ⅱ and Ⅲ in children (q=2.415～11.818,P＜0.05 or P＜0.01),while the contern of blood IGF-1,TGF-β1 and Cys C of level Ⅲ in children was higher than that of the level Ⅱ in children (q=2.577～6.244,P＜0.05 orP＜ 0.01),the difference was statistically significant.Blood IGF-1,TGF-β1 content of children with HSPN were positively correlated with Cys C content of children (r=0.648,0.719,P＜0.05),but blood IGF 1 content was significantly positive correlated with TGF-β1 content (r=0.748,P＜0.05).Conclusion IGF 1 and TGF-β31 partieipated in the pathogenesis of HSPN,and both were correlated with the degree of the pathological damage.%目的 探讨胰岛素样生长因子-1(IGF-1)和转化生长因子-p1 (TGF-β1)在过敏性紫癜性肾损害(HSPN)患儿发病中的作用.方法 选择过敏性紫癜(HSP)患儿135例,根据是否伴有肾损害分为HSP组和HSPN组,比较各组血IGF-1,TG-F-β1,胱抑素C(Cys C)、肌酐(SCr)和尿素氮(BUN)含量,并比较不同病理分级的HSPN患儿血IGF-1,TGF-β1和CysC含量,分析HSPN组血IGF-1,TGF-β1和Cys C含量的相关性.结果 血IGF-1,TGF-β1和Cys C含量在对照组(117.2±18.8 ng/L,164.2士18.4 ng/L,0.9±0.2 mg/L),HSP组(131.7±19.6 ng/L,282.1±28.3 ng/L,1.1±0.2 mg/L),HSPN组(205.3±24.5 ng/L,489.2±32.7 ng/L,1.3±0.3 mg/L)呈逐渐增加趋势(F=4.824～45.066,P值均＜0.01),HSP组、HSPN组均高于对照组(q=3.397～58.931,P值均＜0.01),且HSPN组高于HSP组(q=16.997,35.193,P值均＜0.01),差异均有统计学意义.HSPN患儿血IGF-1(Ⅱ级175.6±20.4 ng/L,Ⅲ级198.5±23.3 ng/L,Ⅳ级241.7±25.1ng/L),TGF-β1(Ⅱ级392.8±38.9 ng/L,Ⅲ级481.3±44.03 ng/L,Ⅳ级537.6士42.9 ng/L),Cys C(Ⅱ级1.1±0.3 mg/L,Ⅲ级1.3±0.4 mg/L,Ⅳ级1.6±0.4 mg/L)含量随着肾脏病理分级的增加而升高(F=6.594～28.317,P值均＜0.01),肾脏病理分级为Ⅵ级的患儿血IGF-1,TGF-β1和Cys C含量高于Ⅱ级和Ⅲ级患儿(q=2.415～11.818,P＜0.05或P＜0.01),而Ⅲ级患儿高于Ⅱ级患儿(q=2.577～6.244,P＜0.05或P＜0.01),差异均有统计学意义.HSPN患儿血IGF-1,TGF-β1含量与Cys C含量呈正相关(r=0.648,0.719,P＜0.05),而血IGF-1含量与TGF-β1含量呈显著正相关(r=0.748,P＜0.05).结论 IGF-1,TGF-β1共同参与了HSPN发病,并且与病理损害程度相关.
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