探讨血清免疫球蛋白及补体检测水平在肾病综合征诊断中的价值

The value of serum immunoglobulin and complement detection in the diagnosis of nephrotic syndrome

目的探讨免疫球蛋白(immunoglobuli,Ig)和补体(complement,C)检测水平在肾病综合征(nephrotic syndrome, NS)中的诊断价值。方法选取2014年12月至2016年12月,四川大学华西医院住院治疗的98例NS患者(观察组),根据患者病情的临床表现分为单纯型NS组(51例)和肾炎型NS组(47例),采集同期100例健康体检者为对照组。采用免疫比浊法检测血清免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、补体成分3(C3)及补体成分4(C4)的结果,比较Ig和补体检测结果在各组间的差异。结果观察组检测IgG和C3水平均低于对照组,检测IgM水平高于对照组,差异有统计学意义(t=6.325、5.182、5.021,P<0.05);检测IgA和C4水平高于对照组,差异无统计学意义(t=1.254、0.983,P>0.05)。肾炎型NS组检测IgG和C3水平均低于单纯型NS组,检测IgM水平高于单纯型NS组,差异有统计学意义(F=4.324、7.326、3.892,P<0.05)。检测IgA和C4水平高于单纯型NS组,差异无统计学意义(F=1.247、1.328,P>0.05)。结论 Ig和C检测是NS患者机体免疫功能状态的常规方法,部分Ig和C水平变化对NS的早期诊断、鉴别诊断及预后有一定的价值。

Objective To explore the clinical value of immunoglobulin(Ig) and complement(C) testing in the diagnosis of nephrotic syndrome(NS). Methods From December 2014 to December 2016, 98 NS patients hospitalized in West China Hospital, Sichuan University were enrolled and divided into simple NS group(51 cases) and nephritis type NS group(47 cases) according to the clinical manifestations of the patients.Meanwhile, 100 healthy individuals were also enrolled as study controls.Blood samples were collected and serum levels of immunoglobulin G(IgG), immunoglobulin M(IgM), immunoglobulin A(IgA), complement 3(C3) and complement 4(C4) were detected using immunoturbidimetric method and were compared. Results The serum levels of IgG and C3 were lower in patients with NS compared to controls, while serum level of IgM was higher(t= 6.325, 5.182, 5.021, P<0.05).The differences of IgA and C4 levels were not statistically significant between the two group(t=1.254, 0.983, P>0.05).The serum levels of IgG and C3 were lower in patients with nephritis type NS compared to those with simple NS, while serum level of IgM was higher(F=4.324, 7.326, 3.892,P<0.05).The differences of IgA and C4 levels were not statistically significant between patients with simple NS and with nephritis type NS(F=1.247, 1.328, P>0.05). Conclusions The serum levels of Ig and C testing can be used as a simple method to assess the immune function of NS patients and the changes of some Ig and C levels have certain clinical value in the early diagnosis,differential diagnosis and prognosis of NS.