原发性激素敏感型肾病综合征患儿血清25-(OH)D_(3)的相关性分析

Correlation Analysis of Serum 25-hydroxyvitamin D3 in Children with Primary Steroid Sensitive Nephrotic Syndrome

目的:探讨儿童原发性激素敏感型肾病综合征(SSNS)患儿血清25羟基维生素D_(3)[25-(OH)D_(3)]与T淋巴细胞亚群及实验室相关指标的表达水平特点及相关性。方法:选取2021年8月—2022年8月在山西省儿童医院肾内科初治的确诊为原发性肾病综合征且经过标准剂量激素治疗4周后尿蛋白阴转的SSNS组患儿45例。同时选取同期年龄、性别相匹配的健康对照组儿童30例。比较两组儿童血清25-(OH)D_(3)、T淋巴细胞亚群、血浆白蛋白(Alb)、血脂测定[总胆固醇(TC)、三酰甘油(TG)]及24 h尿蛋白定量(24 h TPU)水平,分析25-(OH)D_(3)与T淋巴细胞亚群及实验室相关指标的相关性。结果:(1)SSNS组血清25-(OH)D_(3)、Treg细胞、CD_(3)^(+)CD_(8)^(+)(%)、Alb水平均低于健康对照组,差异有统计学意义(P<0.05);24 h TPU、TC、TG、CD_(3)^(+)CD_(4)^(+)(%)、CD_(4)^(+)/CD_(8)^(+)均高于健康对照组,差异有统计学意义(P<0.05)。(2)SSNS组中,血清25-(OH)D_(3)与Treg细胞、CD_(4)^(+)/CD_(8)^(+)、Alb水平呈正相关(β=0.335、0.458、0.343,P<0.05),与CD_(3)^(+)CD_(8)^(+)(%)、24 h TPU、TG、TC呈负相关(β=-0.437、-0.323、-0.325、-0.325,P<0.05)。结论:SSNS患儿存在25-(OH)D_(3)降低及T淋巴细胞亚群失衡,25-(OH)D_(3)与CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)、Treg细胞、24 h TPU、Alb、血脂代谢密切相关。

Objective:To explore the characteristics of expression level and correlation between serum 25-(OH)D_(3)and T lymphocyte subsets and laboratory related indexes in children with primary steroid sensitive nephrotic syndrome.Methods:Fourty-five SSNS patients enrolled in SSNS group who were initially diagnosed with primary nephrotic syndrome in the Department of Nephrology,Shanxi Children’s Hospital from August 2021 to August 2022 and whose urinary protein turned negative after 4 weeks of standard dose prednisone therapy.At the same time,thirty healthy control group children matched in age and sex were selected.The levels of serum 25-(OH)D_(3),T lymphocyte subsets,plasma albumin(Alb),blood lipid determination[total cholesterol(CHO),triglyceride(TG)]and 24-hour urinary protein quantitative(24h TPU)were compared between the two groups,and the correlation between 25-(OH)D_(3)and T lymphocyte subsets and laboratory related indexes was analyzed.Results:(1)The levels of serum 25-(OH)D_(3),Treg cells,CD_(3)^(+)CD_(8)^(+)(%)and Alb in SSNS group were lower than those of healthy control group,with statistically significant difference(P<0.05);24 h TPU,CHO,TG,CD_(3)^(+)CD_(4)^(+)(%),CD_(4)^(+)/CD_(8)^(+)were higher than those of healthy control group,and the difference was statistically significant(P<0.05).(2)In SSNS group,serum 25-(OH)D_(3)was positively correlated with Treg cells,CD_(4)^(+)/CD_(8)^(+)and Alb levels(β=0.335、0.458、0.343,P<0.05).It was negatively correlated with CD_(3)^(+)CD_(8)^(+)(%),24 h TPU,TG and CHO(β=-0.437、-0.323、-0.325、-0.325,P<0.05).Conclusion:Children with SSNS had 25-(OH)D_(3)decreased and T lymphocyte subsets imbalance.25-(OH)D_(3)was closely related to CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+),Treg cells,24 h TPU,Alb and lipid metabolism.