成人紫癜性肾炎患者的免疫状态研究

Analysis of Immune State in Adult Henoch-Schonlein Purpura Nephritis

目的探讨成人紫癜性肾炎患者体液免疫与细胞免疫的变化。方法对44例紫癜性肾炎患者(研究组,其中26例行肾脏病理诊断)和27例健康人(对照组)分别检测血清免疫球蛋白、补体及T淋巴细胞亚群,比较两组之间的差异。根据病理改变及荧光强度,对26例行肾脏病理诊断的患者进行分组,比较不同病理分级、不同荧光强度的患者血清免疫球蛋白或补体水平的差异。结果体液免疫方面:成人紫癜性肾炎患者的IgA、IgM、IgE、C4、IgA/C3、IgA/IgG水平明显高于对照组,差异均有统计学意义(P<0.05),而IgG、C3水平与对照组比较,差异均无统计学意义(P>0.05)。细胞免疫方面:与对照者相比,紫癜性肾炎患者的CD8细胞明显升高(P<0.05),CD16+56细胞明显降低(P<0.01)。不同病理分级患者血清免疫球蛋白及补体水平间差异均无统计学意义(P>0.05)。不同荧光强度患者血清IgG、IgA、IgM及C3水平间差异均无统计学意义(P>0.05)。结论成人紫癜性肾炎体液免疫与细胞免疫均类似于儿童紫癜性肾炎的改变,肾脏免疫反应程度较全身免疫反应具有一定的独立性。

Objective To explore the change of humoral and cellular immune state in adult Henoch-Schonlein purpura nephritis（HSPN）.Methods 44 patients with HSPN in research group（26 of 44 receiving renal biopsy） and 27 healthy people in control group were assigned to receive serum immune globulin check complements check and T cell subgroup check,the differences of which between the two groups were compared.According to pathological degrees and fluorescent intensity,26 patients in the research who received renal biopsy regrouped.The differences of serum immunoglobin and complements were compared among the patients with different degrees of pathology and intensity of fluorescent.Results In humoral immunity,IgA,IgM,IgE,C4,IgA/C3,IgA/IgG were found with an significant increase in HSPN group compared with those in control group,and the difference was significant（P0.05）,while no significant difference was found in IgG and C3 between the two groups（P0.05）.In cellular immunity,compared with those in control group,CD8 in HSPN group was found with an significant increase（P0.05）,CD16＋56was found with a decrease in HSPN group（P0.01）.There were no statistical significance in serum immunoglobin and complements between different pathological grades（P0.05）.There were also no statistical significance in serum IgG,IgA,IgM and C3 between different fluorescent intensity（P0.05）.Conclusion The change of humoral and cellular immune state in adult HSPN was similar to that in children,however,the extent of reaction to renal immunity was more independent than the whole body immunity.