肾病综合征细胞免疫功能动态变化的临床意义

Dynamic changes and the significance in immune functions of lymphocytes in children with nephrotic syndrome

目的 探讨儿童原发性肾病综合征 (NS)淋巴细胞免疫功能的动态变化和可溶性白介素 2受体(sIL 2R)、T细胞亚群、IL 1、IL 6及IL 8改变的临床意义。方法 应用ELISA方法对 2 5例NS活动期和缓解期患儿检测血清和尿液sIL 2R和血清IL 1、IL 6和IL 8浓度。应用流式细胞仪检测T细胞亚群的变化。结果 1.NS活动期组血清和尿液sIL 2R分别高于缓解期组 (P <0 .0 1) ;2 .NS活动期组血清IL 1、IL 6和IL 8明显高于缓解期组 (P <0 .0 1) ;3.NS活动期组CD+ 3 、CD+ 4、CD+ 4/CD+ 8、NK[CD( 16+ 56) ]+ 细胞明显低于缓解期组(P <0 .0 1)。结论 NS患儿细胞免疫功能减低 ,促进IL 1、IL 6和IL 8的产生 ,血和尿sIL 2R及细胞因子的变化可作为NS活动指标之一。

Objectives To explore dynamic changes in immune function of lymphocytes in children with primary nephrotic syndrome(NS)and to clarify the clinical significance of the changes of soluble interleukin-2 receptor (sIL-2R) and T cell subsets,IL-1 ,IL-6, IL-8 in children with NS.Methods The level of sIL-2R in serum and urine was measured with ELISA from 25 NS patients at active stage and 20 of them at remission stage.Meanwhile the level of IL-1 ,IL-6, IL-8 in serum was also measured with ELISA with T cell subsets detected,by flow cytometor. Results 1.The level of sIL-2R in serum and urine was significantly higher in NS patients at active stage than that at remission stage in patients (P<0.01). 2.The level of IL-1 ,IL-6, IL-8 was significantly higher in NS patients at active stage than that at remission stage in patients (P<0.01). 3.The percentage of CD + 3cell, CD + 4 cell, CD + (16+56) cell and the ratio of CD + 4/CD + 8 was significantly lower at NS active stage than that at NS remission stage in patients (P<0.01). Conclusions Cellular immunity of NS patients was reduced, while the production of IL-1 ,IL-6 and IL-8 was accelerated. The elevation of the level of sIL-2R in serum and urine and cytokines can be used as an index of nephrotic syndrome activation.[