原发性肾病综合征患者外周血淋巴细胞亚群、白介素2及其高亲和力受体表达的研究

Lymphocyte Subpopulation, Interleukin-2 and High Affinity In terleukin-2 Receptor Expression in Primary Nephrotic Syndrome

目的 探讨原发性肾病综合征 ( PNS)患者发病期及缓解期的细胞免疫状态。方法 分别采用单克隆抗体致敏红细胞检测法、白介素 2 ( IL - 2 )生物活性检测法和受体的放射性配体结合法 ,对 39例 PNS患者及 2 5例正常对照的外周血淋巴细胞亚群、IL - 2活性及高亲和力白介素 2受体 ( IL - 2 R)的表达进行检测。结果 PNS组2 2例发病期患者的 T淋巴细胞 ( CD3 )、辅助淋巴细胞 ( CD4)、抑制淋巴细胞 ( CD8)以及 IL - 2、IL - 2 R均显著低于对照组 ( P<0 .0 5 ) ;17例缓解期患者的 CD3 、CD4、IL - 2、IL - 2 R高于发病期组 ,但低于对照组 ,且与后两组的上述各项指标均有显著性差异 ( P<0 .0 5 )。结论 PNS患者发病期细胞免疫功能低下 ,缓解期有所恢复 ,但仍未达正常水平。缓解期细胞免疫功能低下可能是 PNS易于复发的原因之一。

Objective To understand the cellular immune respo nse during relapse and remission stage in primary nephrotic syndrome(PNS). Methods We applied the radioligand binding assay (RBA),the bioactivity measurement of IL 2,and mon oclonal antibody sensitized red blood cell method to evaluate the expression of IL 2R, the production of IL 2 and T lymphocyte subsets of PBMC from 22 patien ts suf f ering from PNS, 17 patients with PNS in remission, and 25 normal subjects matche d age and sex. Results CD 3,CD 4,CD 8,IL 2,IL 2R in relapse were significantly lower than those in control ( P <0.05); all above except CD 8 in remission patient s were significantly higher than those in relapse, but lower than those in contr ol ( P <0.05).Conclusion This study suggested that the cell m ediated immunity (CMI) during acute nephrotic phase decreased; the deficiency of CMI of PNS in r emission improved a lot when compared with the acute phase, but still not recov ered completely; the deficiency of CMI with PNS in remission might be one of the causes of easily recurring of PNS.