摘要
目的研究小儿肾积水术后分肾功能(DRF)水平与血清正五聚素-3(PTX3)、免疫球蛋白A(IgA)/补体C3(C3)水平的相关性。方法采用回顾性研究,选择2019年1月至2021年12月新疆医科大学第一附属医院收治的144例肾积水患儿作为研究对象,患儿均行肾盂输尿管成形术,将DRF≥45%定义为肾功能正常,根据术后DRF将患儿分为DRF≥45%组(54例)和DRF<45%组(90例)。收集所有患儿一般资料,包括患儿性别、手术时年龄、发病侧别、手术方式;进行肾脏超声,检测患儿术前患侧肾皮质厚度、术前患侧肾盏大小、术前肾盂前后径、术前长径比、术前横径比;进行肾核素显像检查,评估患儿的术前DRF。以受试者工作特征(ROC)曲线分析术前患侧DRF、PTX3、IgA、IgA/C3预测小儿肾积水术后DRF<45%的价值;采取非条件Logistic逐步回归分析小儿肾积水术后DRF<45%的危险因素;以Spearman系数检验小儿肾积水术后DRF与血清PTX3、IgA/C3水平的相关性。结果与DRF≥45%组相比,DRF<45%组术前患侧DRF较低,PTX3、IgA、IgA/C3水平较高,差异均有统计学意义(P<0.05)。经ROC分析,术前患侧DRF≤40.911%、PTX3≥1.461 ng/mL、IgA≥2.513 g/L、IgA/C3≥2.449是小儿肾积水术后DRF<45%的最佳截断值,均有P<0.05。多因素Logistic回归性分析显示,术前患侧DRF≤40.911%、PTX3≥1.461 ng/mL、IgA≥2.513g/L、IgA/C3≥2.449是小儿肾积水术后DRF<45%的危险因素。经相关性分析,小儿肾积水术后DRF与PTX3、IgA、IgA/C3呈负相关(P<0.05);小儿肾积水术后DRF与C3水平无明显相关性(P>0.05)。结论肾积水患儿术后DRF可能受术前DRF、血清PTX3、IgA及IgA/C3等因素影响,并且PTX3、IgA、IgA/C3与患儿术后DRF呈负相关,临床可在术前检测以上指标以预测患儿术后DRF。
Objective To study the correlation between the level of differential renal function(DRF)and the level of serum n-pentameterin-3(PTX3),immunoglobulin A(IgA)/complement C3(C3)in children with hydronephrosis after operation.Methods A total of 144 children with hydronephrosis admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2021 were selected as the study subjects.All the children underwent pyeloureteroplasty,and DRF≥45%was defined as normal renal function.According to postoperative DRF,the children were divided into DRF≥45%group(54 cases)and DRF<45%group(90 cases).General data of all children were collected,including gender,age at the time of surgery,side of the disease,and surgical method;Renal ultrasound was performed to detect the preoperative thickness of the affected renal cortex,the size of the affected renal calyx,the preoperative APD,the preoperative length to diameter ratio,and the preoperative transverse diameter ratio.Renonuclide imaging was performed to assess preoperative DRF.The value of preoperative DRF,PTX3,IgA,and IgA/C3 in predicting postoperative DRF in children with hydronephrosis was analyzed by receiver operating characteristic(ROC)curve.The risk factors of DRF<45%after hydronephrosis in children were analyzed by stepwise Logistic regression.Spearman coefficient was used to test the correlation between DRF and serum PTX3,IgA/C3 levels in children with hydronephrosis after operation.Results Compared with DRF≥45%group,DRF<45%group had lower preoperative DRF and higher PTX3,IgA and IgA/C3 levels,the differences were statistically significant(P<0.05).According to ROC analysis,preoperative DRF≤40.911%,PTX3≥1.461 ng/mL,IgA≥2.513 g/L and IgA/C3≥2.449 were the optimal truncation values of postoperative DRF<45%in children with hydrrophrosis(P<0.05).Multivariate Logistic regression analysis showed that preoperative DRF≤40.911%,PTX3≥1.461 ng/mL,IgA≥2.513 g/L,IgA/C3≥2.449 were the risk factors for POSTOPERATIVE DRF<45%in children w
作者
热娜·阿布力孜
威力江·赛买提
帕洛克·迪力木拉提
Rena·abliz;Welijiang·saimaiti;Paluoke·dilimulati(Department of Pediatric Urology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830054,China.)
出处
《临床和实验医学杂志》
2022年第19期2096-2099,共4页
Journal of Clinical and Experimental Medicine
基金
中国管理科学研究院教育科学研究所科教创新研究重点课题(编号:KJCX12640)。
关键词
小儿
肾积水
分肾功能
正五聚素-3
免疫球蛋白A
补体C3
Children
Kidney seeper
Differential renal function
N-pentamere-3
Immunoglobulin A
Complement C3
