红细胞免疫黏附功能在儿童IgA肾病中的作用  

Effect of Erythrocytes Immune Adhesion Function in Children with Immunoglobulin A Glomerulonephritis

作　　者：顾岚[1] 何威逊[2] 宋国英[1] 张洁[1] 李军[1] 马岩[1] 

机构地区：[1]吴江市第一人民医院儿科,江苏吴江215200 [2]上海市儿童医院肾内科,上海200040

出　　处：《实用儿科临床杂志》2010年第17期1336-1337,1368,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨红细胞免疫黏附功能在儿童IgA肾病(IgAN)发病机制中的作用。方法将24例IgAN患儿作为IgAN组,30例健康儿童作为健康对照组。采集静脉血1 mL,检测红细胞C3b受体花环率(RCR)、肿瘤红细胞花环率(TRR),将其作为评价红细胞免疫黏附功能的指标,并进行相关性分析。采用PCR加HindⅢ酶切技术,测定红细胞第一补体受体(CR1)密度相关基因多态性:高表达型、中表达型、低表达型(HH型、HL型、LL型)。结果 IgAN组患儿RCR、TRR均低于健康对照组(Pa<0.05),且二者下降均呈显著正相关(Pa<0.05);IgAN患儿红细胞CR1密度相关基因多态性分布以HH型占多数,但百分比较健康对照组显著下降(P<0.05);HL型所占百分比较健康对照组下降,但差异无统计学意义(P>0.05);仅有IgAN组检出1例LL型。在相同基因人群中,IgAN组患儿TRR低于健康对照组(P<0.01);无论是IgAN组还是健康对照组,HH型人TRR均较HL型高(Pa<0.01)。结论 IgAN患儿红细胞膜上CR1活性降低,识别、黏附、清除循环免疫复合物的能力下降。IgAN患儿红细胞免疫黏附功能显著下降在该病的发病机制中起重要作用。红细胞CR1密度相关基因型别与红细胞免疫黏附功能有关,HH型人群较HL型人群高,HL型人群较LL型人群高。IgAN患儿红细胞免疫功能下降可能为继发性下降。Objective To explore the role of erythrocyte immune adhesion function in pathogenesis of IgA glomerulonephritis（IgAN） in children.Methods Twenty-four children with IgAN were enrolled in this study and 30 age and sex-matched healthy children were served as healthy control group.They were gathered venous blood 1 millilitre.The erythrocyte immune adhesion function was measured in all cases by rosette tests：red blood cell C3b receptor rosette rate（RCR） and tumor red blood cell rosette rate（TRR）.In addition,the genomic density polymorphism of complement receptor type 1（CR1） expressed on erythrocyte（HH type,HL type,LL type） in all patients and healthy children were determined by polymerase chain reaction（PCR） and Hind Ⅲ restriction enzyme digestion technique.Results RCR and TRR in IgAN group were significantly decreased than those in healthy control group（Pa0.05）,as well as RCR was positively correlated with TRR,respectively（Pa0.05）.The most of the genomic density polymorphism of CR1 expressed on erythrocyte in IgAN group was HH type.HH type percentage of patients with IgAN was decreased significantly（P0.05）,and HL type percentage in IgAN group showed no significantl difference than in healthy control group.One case with LL type was measured in IgAN group.Statistical correlation existed between TRR in IgAN group and that in healthy control group with the same genotype.TRR of HH type group was higher than that in HL type group,whatever in IgAN group or in healthy control group.Conclusions The decrease of quantities and activation of erythrocytes CR1 lead to lower capacity of identifing,adhering,clearing immune complex.The decrease of the function of erythrocyte immune adhering plays an important role in the pathogenesis in the patients with IgAN.The results of examing CR1 density associated genotype on erythrocytes of patients with IgAN suggest that the ability of erythrocyte immune adhering in HH type is higher than that in HL type and LL type.It is possible that the number of CR

关 键 词：IGA肾病 红细胞 免疫功能 第一补体受体 儿童 

分 类 号：R726.9[医药卫生—儿科]