原发性肾病综合征患儿白细胞介素-4、γ-干扰素与激素疗效的关系

The relationship of interleukin-4 and interferon-γ with steroid effect in children with primary nephrotic syndrome

目的探讨原发性肾病综合征患儿治疗前外周血白细胞介素-4(IL-4)、γ-干扰素(IFN-γ)与激素治疗效应的关系。方法31例原发性肾病综合征患儿于治疗前抽取静脉血分离单个核细胞,加入植物血凝素刺激其生长,取其上清液,用酶联免疫吸附双抗夹心法检测IL-4、IFN-γ,激素治疗8周后根据治疗反应分为激素敏感组(17例)及激素耐药组(14例)。20例健康儿童作为对照组。结果原发性肾病综合征中激素敏感组治疗前外周血IL-4水平明显高于激素耐药组(P<0.01);IFN-γ水平在激素敏感组及激素耐药组之间差异无统计学意义(P>0.05)。结论测定肾病综合征患儿治疗前外周血中的IL-4可以作为预测激素疗效的一项指标。

Objective To study the relationship between the activity of interleukin-4 and interferon- γ with steroid effect in children with primary nephrotic syndrome before initiation of steroid therapy. Methods The activity of interleukin-4 and interferon-γ in the supernatants of monocytes cell cultures activated with phytohemagglutinin was assessed with enzyme-linked immunosorbentassay in 31 children with primary nephrotic syndrome before iniatiation of steroid therapy. After steroid treatment for 8 weeks, data of steroid sensitivity and resistance were analyzed. Results Before initiation of steroid treament, in steroid sensitivity children with primary nephrotic syndrome an increased proliferative response of interleukin-4 was found （P〈0.01）. However, there were no differences in interferon- γ between steroid sensitivity and steroid resistance group （P 〉 0. 05）. Conclusion The activity of interleukin-4 is a useful tool for evaluating the likelihood of steroid sensitivity in children with primary nephrotic syndrome.