原发性肾病综合征儿童尿蛋白与体液免疫关系的研究

A Study on the Relationship Between Urinary Protein Excretion and Humoral Immune Function in Children with Primary Nephrotic Syndrome

目的探讨原发性肾病综合征（PNS）儿童体液免疫功能状态及其与尿蛋白的关系。方法选取初次诊治的PNS患儿64例为病例组，检测其体液免疫指标IgG、IgA、IgM、补体C3及24h尿蛋白定量。以同期健康体检的儿童32例为对照组，检测以上相同指标。将PNS患儿按尿蛋白定量分为两组：A组：24尿蛋白定量为50-100mg／kg;B组：24尿蛋白定量〉100mg／kg。比较病例组及对照组、A组及B组间体液免疫功能的变化；对24h尿蛋白定量与各项体液免疫指标进行相关分析。结果①与对照组比较，PNS患儿血清IgG及补体C3显著降低（P〈0．01及P〈0．05），IgM显著增高（P〈0．01）；②B组IgG及补体C3显著低于A组（P均〈0．05）；③PNS患儿24h尿蛋白定量与血清补体C3呈显著负相关（P〈0．05）。结论PNS患儿存在体液免疫功能异常，异常程度与尿蛋白排泄量有关，体液免疫异常可能参与了儿童PNS的发病。

objective To explore the humoral immune function in children with primary nephrotic syndrome （PNS） and the relationship between humoral immune function and urinary protein. Methods 64 cases of children with the initial diagnosis of PNS were selected as case group, testing their humoral immune index IgG, IgA, IgM, C3 and 24-hour urinary protein quantitative. The same indexes were also tested in 32 healthy children as control group. Children with PNS were divided into 2 groups according to urinary protein： group A： 24 urinary protein quantitative was 50 -100mg/kg; group B： 24 urinary protein quantitative 〉 100mg / kg. Compare the changes of humoral immune function between eases group and control group and between group A and group B; Correlation analysis was done between 24 urinary protein quantitative and every humoral immune index. Results ① Compared with controls, the levels of serum IgG and C3 reduced （P 〈 0.01, P 〈 0.05） and IgM rose significantly （P 〈 0.01） in children with PNS;② The levels of serum IgG and C3 in group B significantly lower than that in group A.③There was significant negative correlation between 24-hour urinary protein quantitative and the lever of serum C3 in in children with PNS（P 〈 0.05）. Conclusion Humoral immune function is abnormal in children with PNS, how abnormal is related to urinary protein excretion. Humoral immune function abnormality may involve in the pathogenesis of PNS in children.