The Serum Levels Of CD146 And Its Clinical Significance In Children With Primary Nephrotic Syndrome

Objective:To examine the level of serum adhesion molecule CD 146 in children with primary nephrotic syndrome and analyze the relationship with the clinical laboratory parameters and the influence after the treatment with glucocorticosteroid meanwhile explore possible significance in clinic and nosogenesis;pathogenesy.Methods:Thirty-three children with primary nephrotic syndrome who admitted to our department between march 2010 and 2011 were investigated, According to therapeutic effect of glucocorticosteroid, we divided these children into SSNS group and SRNS group and meanwhile chose 18 age/sex-matched healthy children as control group. Get last night and empty stomach above 10 hours vein blood and remain peripheral blood as sample. ELISA was used to examine level of serum CD146 in all children. Got peripheral blood CD146 sample again when urine proteinum darkening twice within one week after treatment of prednisone (2mg/kg) in SSNS group. Compare the different of level of serum CD 146 in three groups as well as circa of treatment of prednisone in SSNS group. Meanwhile examine serum-albumin, cholest, creatinine, CysC,β2-MG, PT, APTT, TT, plasma fibrinogen, urina sanguinis NAG enzyme, urinary protein of 24 hours. Analyze the correlation of serum CD 146 and other clinical parameters.Results:1.Among all three groups, age difference have not statistically significant (P>0.05),sexuality difference have not statistically significant (P>0.05).2.Level of serum CD146 in group SSNS and group SRNS was higher than Controls (P<0.05), level of serum CD146 in group SRNS was higher than group SSNS, but the difference have not statistically significant(P>0.05).3.Level of serum CD146 showed descent in group SSNS after treatment of prednisone and the difference had statistically significant(P<0.05).4.Analysis with linear correlation we can get that:in experiment groups the level of serum CD146 showed different positive correlation between serum cholesterol, urinary protein of 24 hours, plasma Fg, urine NAG enzyme and had statistically significant(P<0.05), had no linear correlation between serum-albumin, Scr, CysC, β2-MG, PT, APTT, TT(P>0.05).Conclusions:1. Adhesion molecule CD146 in peripheral blood of PNS children showed reinforcement, level of serum CD146 showed descent tendency in group SSNS after treatment of glucocorticosteroid, and demonstrate that there are endothelium functional disorder in PNS children and adhesion molecule CD 146 may participate pathogenesis of NS cell immunity.2. Compare with the group SSNS, level of CD146 in group SRNS show elevated tendency but the differency had not statistically significant (P<0.05). If it can be used as index to evaluate PNS children GC resistant also need further obersavation through large samples and nephridial tissue biopsy.3. Level of serum CD 146 show positive correlation with urinary protein of 24 hours, serum cholesterol and plasma Fg, confirmed from another aspect that children with PNS exist coagulopathy and endothelium functional disorder and hint that CD146 will be the index to evaluate hypercoagulabale state in children of PNS and meanwhile provide evidence to chose the opportunity of anticoagulant therapy.4.Level of serum CD146 in children of PNS showed positive correlation with urine NAG enzyme and hint that may be exist peritubular capillary affection to affect nephric tubule function.