IgA肾病及过敏性紫癜性肾炎患儿血清半乳糖缺乏IgA_1测定的临床意义  

Clinical Significance of Galactose-deficient IgA1 Determination in Children with IgA Nephropathy and Henoch-Schnlein Purpura Nephritis

作　　者：邹敏书[1] 余健[1] 聂国明 尹晓玲[2] 周建华[2] 

机构地区：[1]广州军区武汉总医院儿科,湖北武汉430070 [2]华中科技大学同济医学院附属同济医院儿科

出　　处：《华南国防医学杂志》2012年第6期542-544,556,共4页Military Medical Journal of South China

基　　金：国家自然科学基金项目(81070557)

摘　　要：目的分析IgA肾病(IgA nephropathy,IgAN)及过敏性紫癜性肾炎(Henoch-Schnlein purpura nephri-tis,HSPN)患儿中IgA1(Gd-IgA1)水平的临床意义。方法 45例研究对象被分为IgAN组、HSPN组、对照组,每组15例。磁珠分选外周血初始B细胞(CD27-IgD+),加滤泡辅助性T细胞(T follicular helper,Tfh)相关因子共培养,酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)测定细胞培养上清液IgA分泌,散大蜗牛凝集素(helix asper-sa,HHA)ELISA测定半乳糖缺乏的IgA1(Gd-IgA1)水平,同时测定血清中的IgA、Gd-IgA1水平。结果 IgAN、HSPN及对照组细胞培养上清液IgA水平分别为(65.4±11.3)ng/ml、(63.6±9.4)ng/ml、(60.7±12.8)ng/ml;Gd-IgA1水平分别为(91.5±11.5)U/ml、(88.0±10.5)U/ml、(75.7±12.8)U/ml。IgAN、HSPN及对照组血清IgA水平分别为(537.0±100.0)μg/ml、(508.0±95.2)μg/ml、(498.0±85.4)μg/ml;Gd-IgA1水平分别为(2495.0±278.5)U/ml、(2580.0±254.0)U/ml、(1897.0±210.9)U/ml。与对照组相比,IgAN组和HSPN组细胞培养上清液及血清IgA水平无统计学差异(P>0.05);细胞培养上清液及血清Gd-IgA1水平显著升高,差异有统计学意义(P<0.01)。IgAN组及HSPN组细胞培养上清液IgA、Gd-IgA1及血清IgA、Gd-IgA1水平均无统计学差异(P>0.05)。结论Tfh细胞介导Gd-IgA1的生成增加,在IgAN和HSPN发病起作用;血清Gd-IgA1可能是间接反映IgAN和HSPN的无创性指标之一。Objective To detect the levels of galactose-deficient IgA1（Gd-IgA1） in children with IgA nephropathy（IgAN） and Henoch-Schnlein purpura nephritis （HSPN）. Methods The subjects were divided into IgAN group（n=15）,HSPN group（n=15） and the control group（n=15）.Native B cells（CD27-IgD＋） were sorted by magnetic bead from peripheral blood cells and cultured with Tfh-related cells factor.The levels of IgA and Gd-IgA1 in serum and the culture supernate were evaluated by enzyme-linked immunosorbent assay（ELISA） and the helix aspersa（HAA）-ELISA respectively. Results In the culture supernate,the levels of IgA were（65.4±11.3） ng/ml,（63.6±9.4） ng/ml,（60.7±12.8） ng/ml,and the levels of Gd-IgA1 were（91.5±11.5） U/ml,（88.0±10.5） U/ml,（75.7±12.8） U/ml in IgA,HSPN and control groups respectively.In the serum,the levels of IgA were（537.0±100.0） μg/ml,（508.0±95.2） μg /ml,（498.0±85.4） μg/ml, and the levels of Gd-IgA1 were（2495.0±278.5） U/ml,（2580.0±254.0） U/ml,（1897.0±210.9） U/ml in IgA, HSPN and control groups respectively.Compared with those in control group,the levels of IgA in the culture supernate and serum were not significantly different（P0.05）,but the levels of Gd-IgA1 were significantly increased in IgA and HSPN groups（P0.01）.There was no significant difference in IgA and Gd-IgA1 in the culture supernate and serum between IgA and HSPN groups（P0.05）. Conclusion Increased Gd-IgA1 moderated by Tfh cells is correlated with the pathogenesis of IgAN and HSPN.Serum Gd-IgA1 may be a noninvasive biomarker of IgAN and HSPN.

关 键 词：IGA肾病 紫癜性肾炎 滤泡辅助性T细胞 半乳糖缺乏的IgA1 

分 类 号：R593[医药卫生—内科学]