目的 分析尿液相关指标中性粒细胞明胶酶相关脂质运载蛋白（neutrophil gelatinase‑associated lipocalin, NGAL）、尿微量白蛋白及粪便钙卫蛋白联合检测对儿童IgA血管炎肾炎（IgA vasculitis with nephritis, IgAVN）的早期预警价值。 方法 选取2024年1月—2025年12月在宜春市人民医院治疗的90例IgAV患儿与50例健康体检儿童为研究对象。依据入院时及随访3个月的尿液检测结果，将IgAV患儿分为单纯IgAV组（48例）与IgAVN组（42例，尿液检测异常），并将IgAVN组细化为轻度组（25例）和中重度肾损伤组（17例）。通过Pearson相关分析、多因素logistic回归及受试者操作特征曲线，分析各检测指标对IgAVN的诊断与预警价值。 结果 IgAVN组的尿液NGAL、尿微量白蛋白及粪便钙卫蛋白水平均显著高于IgAV组及对照组（P<0.05）。中重度肾损伤患儿的尿液NGAL、尿微量白蛋白及粪便钙卫蛋白水平均高于轻度肾损伤患儿（P<0.05）。相关性分析显示，以上3项指标与IgAVN严重程度呈显著正相关（P<0.05）。受试者操作特征曲线分析表明，该3项指标联合检测对IgAVN的预警效能显著优于单项检测（P<0.05）。 结论 尿液NGAL、尿微量白蛋白及粪便钙卫蛋白联合检测可有效提升儿童IgAVN的早期预警效果，可为临床早期干预、改善患儿预后提供可靠的实验室依据。

Objective To evaluate the early warning value of combined detection of urinary neutrophil gelatinase-associated lipocalin (NGAL), urinary microalbumin and fecal calprotectin for IgA vasculitis with nephritis (IgAVN). Methods A total of 90 children with IgAV and 50 healthy children undergoing physical examination at Yichun People's Hospital from January 2024 to December 2025 were enrolled. Based on urinalysis at admission and at 3-month follow-up, IgAV cases were classified into a simple IgAV group (n=48) and an IgAVN group (n=42; abnormal urinalysis). The IgAVN group was further divided into a mild renal injury subgroup (n=25) and a moderate-to-severe renal injury subgroup (n=17). Pearson correlation analysis, multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were used to assess the diagnostic and early warning value of each marker. Results Levels of urinary NGAL, urinary microalbumin and fecal calprotectin in the IgAVN group were significantly higher than those in the simple IgAV group and the control group (P<0.05). Children with moderate-to-severe renal injury had higher levels of all three markers than those with mild renal injury (P<0.05). Correlation analysis showed that all three markers were significantly positively correlated with the severity of renal injury (P<0.05). ROC analysis indicated that combined detection of the three markers provided significantly better early warning performance than any single marker (P<0.05). Conclusions Combined detection of urinary NGAL, urinary microalbumin and fecal calprotectin improves early warning for IgAVN in children, providing a reliable laboratory basis for early clinical intervention and better prognosis.