检测微小病变型肾病综合征患者腺苷脱氨酶的临床意义

Detecting and Analysising Adenosine Deaminase Activity in Patiens with Minimal Change Nephrotic Syndrome

目的:检测微小病变型肾病综合征(MCNS)患者血清及淋巴细胞内腺苷脱氨酶(S-ADA,L-ADA)活性的变化,以评估其细胞免疫状态,并探讨临床意义。方法:选取初发的MCNS患者30例,应用免疫学技术测定不同的病程阶段患者的S-ADA及L-ADA活性,比较ADA活性变化。结果:激素治疗前,激素敏感组(SS)、激素依赖组(SD)和激素抵抗组(SR)两两比较无统计学意义(P>0.05),经激素足量治疗4周后,SS组、SD组S-ADA和L-ADA活性均下降,SS组下降最明显(P<0.01),而SR组无变化(P>0.05);短期缓解期组S-ADA活性降至对照组水平,L-ADA活性也下降,但与对照组相比,其水平仍高(P<0.05);长期缓解期组S-ADA及L-ADA活性与对照组相比,无统计学差异(P>0.05);S-ADA及L-ADA活性有显著的相关性(r=0.811,P<0.01)。结论:MCNS患者存在着细胞免疫的紊乱,检测S-ADA及L-ADA活性可作为判断临床治疗效果的指标之一。

Objective： Detecting adenosine deaminase （ADA） activity in the serum （S- ADA） and lymphocytes （L - ADA） of minimal change nephrotic syndrome（MCNS） patients, to evaluate cell - mediated immunity status and approach clinical significance. Methods：Choosed 30 incipient MCNS patients. Detected S- ADA and L - ADA activity of different clinical stages MCNS patients and 20 healthy controls by immuno - technique respectively. Results： There were not statistically significant to compared SS group, SDgroup and SR group before prednisone therapy. After prednisone therapy 4 weeks, the S- ADA and L- ADA activity was significantly decreased in steroid dependent patients and steroid sensitive patients, and steroid sensitive patients decreased obviously, but steroid resistant patients had no charged. In short- remission group, the S- ADA levels showed not statistically significant in comparison with controls, but the mean L - ADA levels was statistically significant when compared with controls. The S- ADA and L- ADA enzyme activity normalized in the long - term remission group. A significant positive correlation was found between S - ADA and L- ADA levels（ r = 0. 811 ,P〈0.01）. Conclusion：Patients with MCNS would be in depressed cell - mediated immunity status, S - ADA and L - ADA activity cound be a marker of clinical therapeutic efficacy.