原发性肾病综合征患儿T淋巴细胞免疫及细胞因子的临床意义

Clinical significance on T lymphocyte immunity and cytokines in children with primary nephrotic syndrome

目的探讨原发性肾病综合征(PNS)患儿T淋巴细胞免疫及细胞因子变化的临床意义。方法选取2015年6月~2019年3月赣州市人民医院收治的30例PNS患儿,根据疾病进展情况分为活动期组(13例)和缓解期组(17例),选择同期30例健康儿童作为对照组。分析三组CD3+、细胞毒性T细胞(Tc)、辅助性T细胞(Th)、Th/Tc及白细胞介素-6(IL-6)水平。结果三组的CD3+水平比较,差异无统计学意义(P>0.05)。活动期组及缓解期组的Th、Th/Tc水平均低于对照组,差异有统计学意义(P<0.05);活动期组及缓解期组的Tc及IL-6水平均高于对照组,差异有统计学意义(P<0.05)。活动期组的Th、Th/Tc水平均低于缓解期组,差异有统计学意义(P<0.05);活动期组的Tc及IL-6水平高于缓解期组,差异有统计学意义(P<0.05)。IL-6与Tc成正相关(r=0.91,P<0.01),与Th成负相关(r=-0.92,P<0.05),与Th/Tc成负相关(r=-0.90,P<0.05)。结论PNS患儿的T淋巴细胞亚群及细胞因子水平较正常儿童均有所变化,两者可能在PNS发病中起到一定作用。

Objective To investigate the clinical significance of the changes of T lymphocyte immunity and cytokines in children with primary nephrotic syndrome(PNS).Methods A total of 30 children with PNS admitted to our hospital from June 2015 to March 2019 were selected as the research objects and divided into active group(13 cases)and remission group(17 cases)according to disease progression.Meanwhile,30 healthy children were selected as the control group.The levels of CD3+,cytotoxic T cell(Tc),helper T cell(Th),Th/Tc and interleukin-6(IL-6)in the three groups were compared.Results There was no statistically significant difference in CD3+level among the three groups(P>0.05).Th and Th/Tc levels in the active group and the remission group were lower than those in the control group,and the differences were statistically significant(P<0.05).Tc and IL-6 levels in the active group and the remission group were higher than those in the control group,and the differences were statistically significant(P<0.05).Th and Th/Tc levels in the active group were lower than those in the remission group,and the differences were statistically significant(P<0.05).Tc and IL-6 levels in the active group were higher than those in the remission group,and the differences were statistically significant(P<0.05).IL-6 was positively correlated with Tc(r=0.91,P<0.01),negatively correlated with Th(r=-0.92,P<0.05)and negatively correlated with Th/TC(r=-0.90,P<0.05).Conclusion There are changes in T lymphocyte subsets and cytokines in children with PNS,which may play a role in the pathogenesis of PNS.