儿童原发性肾病综合征免疫发病机理研究

The immuno-pathogenesis in children with primary nephrotic syndrome

目的 通过检测原发性肾病综合征 (PNS)患儿的免疫球蛋白 (Ig)及T细胞功能 ,探讨PNS的发病机理。方法 用流式细胞技术、ELISA法及单向免疫扩散法检测 32例PNS患儿血中Ig浓度及PBMC表达膜蛋白分子CD30、细胞因子、及Ig和IgG亚类水平 ,与 2 5例健康对照比较。结果 PNS患儿血中IgG(4 337± 1 2 4 1,对照 6 175± 1 2 2 5 ,g/L)、IgM(1 1± 0 34,对照1 4 4± 0 35 ,g/L)及IgG亚类 (G1,2 4 5 8± 1 2 6 ,对照 3 80 5± 0 78,g/L ;G3:0 375± 0 0 8,对照 0 375± 0 117,g/L)显著下降 ,而血IgE(2 99± 2 35 ,对照 1 1± 0 7,mg/L)增高 ;PBMC表达CD30 (中位数 :10 4 ,对照 3 6 % )过度、产生IL 4 (2 16 6 8,对照2 1 6 8,ng/L)、IL 5 (19 14 ,对照 ,8 4 6 ,ng/L)显著高于正常对照组。结论 儿童PNS存在的Ig合成异常及T细胞功能紊乱可能是本病的发病机理之一。

Objective To observe the levels of serum Ig and the states function of T cells in the children with primary nephrotic syndrome in the acute phase,through direction the TH2 type cytokines levels and membrance CD30 expresses on PBMC,and explore the pathogenesis Methods The cells count of CD30 expression in PBMC were determined by flow cytometry IgA,IgG,IgM,IgE,IgG subsets and cytokines were detected by radial immunodiffusion and ELISA Results The serum IgE(2 99±2 35,controls, 1 1±0 7mg/L),the IL 4(mean:216 68,controls,21 68ng/L),IL 5(1914,controls,8 46ng/L)levels in the supernatants of cultured PBMC and the CD30 (mean:10 4,controls,3 6%)expression on PBMC of PNS patients,were increased significantly in contrast to the normal controls The serum IgG(4 337±1 241,controls,6 175±1 225,g/L)and IgM(1 1±0 34,controls,1 44±0 35g/L)levels,and Ig G subsete(G1,2 458±1 26,controls,3 805±0 78g/L,G3,o 375±0 08,controls,0 375±0 117,g/L) were decreased Conclusion The Ig production were abnormal and the dysfunction of T cell were related to the pathogenesis of PNS patients