肾病综合征患者淋巴细胞内腺苷脱氨酶活性变化及意义

Lymphocyte Adenosine Deaminase Activity in Patients with Primary Nephrotic Syndrome and Its Clinical Significance

目的:检测原发性肾病综合征(PNS)患者淋巴细胞内腺苷脱氨酶(L-ADA)活性的变化,以评估患者的细胞免疫状态,并探讨其临床意义。方法:研究分4组:正常对照组,活动期PNS组,短期缓解期PNS组和长期缓解期PNS组。活动期PNS组又分为激素敏感组(SS)、激素依赖组(SD)和激素抵抗组(SR)。应用免疫学技术测定患者外周血L-ADA活性,比较上述几组L-ADA的活性。结果:与对照组相比,活动期PNS患者L-ADA活性显著增高(P<0.01);在活动期SD组较SS组高,SR组最高;与活动期组相比,短期缓解期组L-ADA活性下降(P<0.05),但仍显著高于对照组(P<0.05);长期缓解期组与活动期组相比,L-ADA活性下降(P<0.05),但与短期缓解期组和对照组相比均无明显差异(P>0.05)。结论:PNS患者存在着细胞免疫的紊乱,检测外周血L-ADA活性可作为判断临床疗效的指标之一。

Objective：To detect adenosine deaminase （ADA） activity in lymphocytes （L-ADA） of different steroid response and different clinical stages patients with primary nephrotic syndrome , to evaluate cell-mediated immunity status. Methods：Detected L-ADA activity of in active nephrotic syndrome （ANS） patients , patients with PNS in short-term remission , patients with PNS in long-term remission and 20 healthy controls by immuno-technique respectively. Results： The mean L-ADA levels were significantly raised in ANS and in its sub-groups in comparison with controls（P〈0.05 or P〈0.01 ）. The ADA activity was significantly more elevated in steroid dependent PNS patients than steroid sensitive PNS patients （P〈0.01）, and steroid resistant PNS patients had the highest enzymatic levels. In remission, the mean L-ADA was statistically significant when compared with controls（P〈0.05）,while enzyme activity normalized in the long-term remission group（P〉0.05）. Conclusion： Patients with PNS would he in depressed cell-mediated immunity status. L-ADA activity eound be a marker of clinical therapeutic efficacy.