原发性肾病综合征血液 尿液检测指标变化及其相关性研究

The changes of serum and urinary IFN-γ, IL-13 and TGF-β1 in children with primary nephrotic syndrome and their relationship

目的探讨原发性肾病综合征(PNS)患儿血、尿干扰素-γ(IFN-γ)、白介素-13(IL-13)、转化生长因子-β1(TGF-β1)的变化及相互关系。方法浙江省宁波市妇女儿童医院2008年3月至2008年12月收治的PNS患儿22例,采用ELISA法检测入院时和缓解后血清及尿液IFN-γ、IL-13、TGF-β1;采用直线相关分析法分析患儿入院时各细胞因子间相关性。另检测20名健康儿童血、尿细胞因子作为对照。结果 PNS组患儿入院时血清IFN-γ、IL-13均显著高于对照组,差异有统计学意义(q值分别为24.186、29.727,P均<0.01);缓解后均虽显著下降,但仍显著高于对照组,差异有统计学意义(q值分别为9.074、7.000,P均<0.01)。入院时血清TGF-β1显著高于对照组(q=19.192,P<0.01),缓解后显著下降,与对照组比较,差异无统计学意义(q=0.581,P>0.05)。入院时尿液IFN-γ、IL-13均显著高于对照组,差异有统计学意义(q值分别33.866、26.422,P均<0.01);缓解后虽均下降,但仍显著高于对照组(q值分别为4.073、6.195,P均<0.01)。入院时尿液TGF-β1显著高于对照组(q=28.160,P<0.01),缓解后显著下降,与对照组比较差异无统计学意义(q=0.251,P>0.05)。血清IFN-γ与IL-13呈显著正相关(r=0.35,P<0.01),血清INF-γ与TGF-β1、IL-13与TGF-β1均无显著相关性(P均>0.05)。尿液各细胞因子间、血清各细胞因子间比较,均无显著相关性(P均>0.05)。结论 IFN-γ、IL-13、TGF-β1可能均参与PNS发病,各因子间可能存在一定关系,但多数并不密切。

Objective To investigate the changes of serum and urinary interferon -gamma （IFN- γ ）, interleukin-13 （IL-13 ） and transforming growth factor beta 1 （TGF- β1 ） in the children with primary nephrotic syndrome （PNS） and their relationship. Methods The levels of IFN- γ , IL-13 and TGF- β1 in the serum and urin of 22 children with PNS were assayed at admission and alleviation respectively by ELISA. The relationship among IFN- γ , IL-13 and TGF- β 1 in serum and urin was detemined by linear correlation analysis .In addition, 20 healthy children were included as control group. Results The levels of serum and urinary IFN- γ and IL-13 at admission were significantly higher than the control group （q = 24.186, 29.727, 33.866, 26.422 respectively, all P 〈 0.01 ）, and markedly dropped, but were still significantly higher than the control group （q = 9.074,7.000, 4.073, 6.195 respectively, all P 〈 0.01 ）at alleviation . The serum and urinary TGF-β1 was markedly increased and dropped at admission and alleviation respectively （q = 19.192, 28.160 respectively, all P 〈 0.01 ）, and not significanty different （ q = 0.581, 0.251 respectively, all P 〉 0.05 ） compared to the control group at alleviation . Serum IFN- γ and serum IL-13 had a significant positive correlation （r = 0.35, P 〈 0.01 ）, but not significantly correlated to serum IFN- γ with serum TGF- β1 and serum IL-13 with serum TGF- β 1 . Each correlation of IFN- γ , IL-13 and TGF- β1 in urin respectively and each relation of them in serum and urin were not markedly found . Conclusions IFN- γ , IL-13, TGF- β1 may be involved in the pathogenesis of PNS. The cytokines may exist a certain degree of relationship, but the majority is not close.