肾病综合征患儿血清细胞因子水平及T细胞亚群变化分析和临床价值研究

Analysis and clinical value of serum cytokine levels and T cell subsets in children with nephrotic syndrome

目的探讨肾病综合征患儿血清细胞因子水平及T细胞亚群变化及价值。方法选取2019年4月至2020年4月因肾病综合征来平舆县人民医院接受治疗的42例患儿为研究组,并依据其病情分为缓解组(处于疾病缓解期,26例)与活动组(处于疾病活动期,16例)。选取同期来平舆县人民医院体检的30名健康儿童为对照组。缓解组男16例,女10例,年龄(5.7±1.7)岁,病程(9.9±1.5)个月。活动组男12例,女4例,年龄(5.6±1.8)岁,病程(10.2±1.3)个月。对照组男23例,女7例,年龄(5.9±1.4)岁。抽取3组空腹静脉血,分别采用全自动生化分析仪检测白介素-2(interleukin-2,IL-2)、干扰素-γ(interferon-gamma,IFN-γ)、白介素-6(interleukin-6,IL-6)及白介素-10(interleukin-10,IL-10)。采用流式细胞仪检测其T淋巴细胞亚群指标,如CD3、CD4、CD8及CD4/CD8。分析比较3组结果。结果缓解组IL-2、IFN-γ、IL-6、IL-10水平分别为(2.0±0.6)、(4.1±1.9)、(4.0±0.6)、(3.4±1.1)ng/L,活动组分别为(2.3±1.0)、(4.9±2.0)、(4.7±0.9)、(7.4±2.0)ng/L,对照组分别为(3.3±0.8)、(5.9±2.1)、(3.5±1.3)、(2.6±0.6)ng/L(F=10.172、10.391、10.537、11.010,均P<0.05)。对照组CD4、CD3/CD8分别为(33.8±6.4)%、(1.59±0.56),活动组分别为(33.6±3.5)%、(1.48±0.63),缓解组分别为(37.1±6.7)%、(1.75±0.63)(F=10.391、11.935,均P<0.05),而对照组与活动组CD4、CD3/CD8差异无统计学意义(均P>0.05);对照组、缓解组、活动组CD3分别为(64.7±6.5)%、(65.9±5.1)%、(64.1±6.7)%,CD8分别为(22.8±4.0)%、(22.7±4.4)%、(24.1±3.6)%,差异无统计学意义(均P>0.05)。结论肾病综合征患儿均存在血清细胞因子与T细胞淋巴亚群异常情况,并在其发病机制中占据重要作用,通过进行上述指标监测能够预测患儿疾病发生与发展。

Objective To investigate the changes of serum cytokine levels and T cell subsets in children with nephrotic syndrome.Methods A total of 42 children with nephrotic syndrome treated at People's Hospital of Pingyu County from April 2019 to April 2020 were selected,and were divided into a remission group(in remission,26 cases)and an active group(in the active stage of the disease,16 cases).Thirty healthy children who came to People's Hospital of Pingyu County for physical examination during the same period were selected as a control group.There were 16 males and 10 females in the remission group,with an age of(5.7±1.7)and a disease course of(9.9±1.5)months.There were 12 males and 4 females in the active group,with an age of(5.6±1.8)and a disease course of(10.2±1.3)months.There were 23 males and 7 females in the control group,with an age of(5.9±1.4).The fasting venous blood of the three groups'children was collected,and the automatic biochemical analyzer was used to detect the levels of interleukin-2(IL-2),interferon-gamma(IFNγ),interleukin-6(IL-6),and interleukin-10(IL-10).Flow cytometry was used to detect T cell subsets,such as CD3,CD4,CD8,and CD4/CD8.The results were analyzed and compared.Results The levels of IL-2,IFNγ,IL-6,and IL-10 were(2.0±0.6),(4.1±1.9),(4.0±1.1),and(3.4±1.1)ng/L in the remission group,were(2.3±1.0),(4.9±2.0),(4.7±0.9),and(7.4±2.0)ng/L in the active group,and were(3.3±0.8),(5.9±2.1),(3.5±1.3),and(2.6±0.6)ng/L in the control group(F=10.172,10.391,10.537,and 11.010;all P<0.05).The CD4 and CD3/CD8 were(33.8±6.4)%and(1.59±0.56)in the control group,were(33.6±3.5)%and(1.48±0.63)in the active group,and were(37.1±6.7)%and(1.75±0.63)in the remission group(F=10.391 and 11.935;both P<0.05).There were no statistical differences in the CD4 and CD3/CD8 between the control group and the active group(both P>0.05).The CD3 in the control group,remission group,and active group were(64.7±6.5)%,(65.9±5.1)%,and(64.1±6.7)%,and the CD6 were(22.8±4.0)%,(22.7±4.4)%,and(24.1±3.6)%,with no statistical differences between the 3 groups(all P>0.05).Conclusions Children with nephrotic syndrome have abnormal serum cytokines and T cell subsets,which play an important role in the disease's pathogenesis.The monitoring of these indicators can predict the disease's occurrence and development in children.