儿童原发性肾病综合征外周血辅助性T淋巴细胞亚群的变化  

Changes of T-helper lymphocyte subsets in children with primary nephrotic syndrome

作　　者：张秋业[1] 董增义[1] 刁锡东[1] 孙大庆[1] 

机构地区：[1]青岛大学医学院附属医院儿科,山东青岛266003

出　　处：《中国实用儿科杂志》2008年第2期130-132,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨辅助性T淋巴细胞（Th细胞）亚群紊乱与儿童原发性肾病综合征（PNS）发病的关系。方法选择2000年6月至2005年6月青岛大学医学院附属医院儿科收治的初发PNS患儿35例为研究对象,以15名健康儿童为对照,采用流式细胞术检测35例初发PNS患儿外周血Th细胞亚群,其中22例激素敏感者于缓解期进行复查。结果初发PNS患儿激素治疗前外周血Th1、Th2细胞百分率分别为（7.2±3.6）%和（9.7±4.5）%,与正常对照组[分别为（13.5±5.3）%和（4.5±2.9）%]比较,PNS患儿Th1细胞明显减少而Th2细胞明显增多,PNS组Th1/Th2比值（0.79±1.02）显著低于对照组（3.71±1.92）,差异均有统计学意义（P〈0.01）;激素敏感PNS组治疗前外周血Th1细胞百分率[（6.2±3.9）%]明显低于非激素敏感组[（9.0%±3.1）%]（P〈0.05）,而Th2细胞百分率[（9.9±3.7）%]和Th1/Th2比值（0.70±1.14）与非激素敏感组[分别为（9.4±5.2）%和（0.94±1.06）]比较差异无显著性（P〉0.05）。激素敏感组患儿缓解期（隔日疗法6-8周后）与活动期比较,Th1细胞和Th1/Th2比值显著增高而Th2细胞明显下降（P〈0.01）,而与对照组比较差异均无统计学意义（P〉0.05）。结论Th细胞亚群紊乱与儿童PNS的发病关系密切,检测初发PNS患儿外周血Th细胞亚群对预测激素疗效有一定帮助。Objective To investigate the relationship between the changes of T-helper lymphocyte （ Th ） subsets in peripheral blood and primary nephritic syndrome（PNS） in children. Methods Samples of 15 healthy children were used as normal control group. Thirty-five children with PNS were involved in this study. The flow cytometry was applied to analysis of Th subsets. In the 22 children with PNS of remission the Th subsets were reexamined. Results Significant decreases of Th1 cell and ratio of Th1/Th2 and significant increase of Th2 in children with initial PNS were found, compared with those in normal controls（ P 〈 0. 01） ; Th1 cell of steroid-sensitive group in active phase before therapy was significantly lower than that of non-steroid-sensltive group （ P 〈 0. 05） , while no obvious differences in Th2 cell or ratio of Th1/Th2 existed （ P 〉 0. 05） ; Th1 cell and ratio of Th1/ Th2 of steroid-sensitive PNS during remission period were obviously increased than those in active stage,and it was the opposite case in Th2（ P 〈 0. 01 ） , while no obvious distinction was found com- pared with those of normal controls （ P 〉 0. 05 ）. Conclusion The disorder of Th subsets is associated with PNS in chil- dren. In children with initial PNS, the examination of Th subsets in peripheral blood will Be of some help to calculation of steroid curative effect.

关 键 词：原发性肾病综合征 辅助性T淋巴细胞亚群 儿童 流式细胞术 

分 类 号：R72[医药卫生—儿科]