Abstract: Objective To analyze the changes in serum levels of periostin (POSTN), pentraxin-3 (PTX3), and soluble fms-like tyrosine kinase receptor 1 (sFlt-1) in children with Henoch-Schönlein purpura nephritis (HSPN) and their clinical significance. Methods A total of 77 pediatric patients diagnosed with HSPN and admitted to the Jinshui District General Hospital, Zhengzhou City, from October 2021 to February 2024 were enrolled as the study group, while another 77 healthy individuals undergoing physical examinations during the same period served as the control group. At admission, serum levels of POSTN, PTX3, and sFlt-1, along with urinary microalbumin, creatinine, and urea nitrogen, were compared between the two groups to analyze their correlations. Additionally, the serum marker levels were compared among patients stratified by different pathological grades and clinical outcomes at admission, and their predictive value for clinical outcomes was investigated. Results The levels of serum POSTN, PTX3, sFlt-1, along with urinary microalbumin, creatinine, and urea nitrogen at admission in the study group were significantly higher than those in the control group (P<0.05). The serum levels of POSTN, PTX3, and sFlt-1 at admission in patients were positively correlated with renal function, urinary microalbumin, creatinine, and blood urea nitrogen (P<0.05). The serum levels of POSTN, PTX3 and sFlt-1 at admission in children with nephritis grade I-III were significantly lower than those in children with nephritis grade Ⅳ-Ⅵ (P<0.05); compared with the children with treatment failure, the serum levels of POSTN, PTX3 and sFlt-1 at admission in the effective children were significantly lower (P<0.05); the AUCs for predicting treatment failure based on serum POSTN, PTX3, sFlt-1 levels individually and jointly at admission were 0.837, 0.828, 0.832, and 0.935, respectively. Conclusion Serum POSTN, PTX3, and sFlt-1 play a role in the onset and progression of HSPN and are correlated with the renal pathological conditions in children with HSPN. These markers can effectively indicate the clinical therapeutic efficacy in children and hold significant value in predicting treatment outcomes.

Key words: periostin, pentraxin-3, soluble fms-like tyrosine kinase receptor 1, Henoch-Schönlein purpura nephritis

摘要： 目的 分析血清骨膜蛋白（POSTN）、正五聚蛋白-3（PTX3）、可溶性fms样酪氨酸激酶受体-l（sFlt-1）在紫癜性肾炎（HSPN）患儿血清中的水平变化及临床意义。方法 选取郑州市金水区总医院2021年10月—2024年2月收治的77例HSPN患儿为研究组,另选取同期77名健康体检者为对照组;对比2组入院时血清POSTN、PTX3、sFlt-1及尿微量白蛋白、肌酐、尿素氮水平,分析其相关性,对比不同病理分级及临床疗效患儿入院时血清各指标水平,探讨其对临床疗效的预测价值。结果 研究组入院时血清POSTN、PTX3、sFlt-1及尿微量白蛋白、肌酐、尿素氮水平显著高于对照组（P<0.05）;患儿入院时血清POSTN、PTX3、sFlt-1水平均与尿微量白蛋白、肌酐、尿素氮呈正相关（P<0.05）;肾炎Ⅰ~Ⅲ级患儿入院时血清POSTN、PTX3、sFlt-1水平显著低于肾炎Ⅳ~Ⅵ级患儿（P<0.05）;与无效患儿相比,入院时治疗有效患儿血清POSTN、PTX3、sFlt-1水平显著降低（P<0.05）;入院时血清POSTN、PTX3、sFlt-1水平单独及联合预测治疗无效的曲线下面积（AUC）分别为0.837、0.828、0.832和0.935。结论 血清POSTN、PTX3、sFlt-1参与HSPN的发生、发展过程,与HSPN患儿肾脏病理状态有关,可有效反映患儿临床疗效,对预测患儿治疗效果具有重要价值。

关键词: POSTN、PTX3、sFlt-1, 紫癜性肾炎