肾病综合征患儿细胞免疫和细胞因子的变化及其意义  

Changes of cellular immune and cytokine with nephrotic syndrome

作　　者：于力[1] 卓美瑛[1] 杨小苏[1] 翁志媛[1] 张又祥[1] 钟志敏[1] 

机构地区：[1]广州市第一人民医院儿科,510180

出　　处：《中国实用儿科杂志》2001年第8期483-485,共3页Chinese Journal of Practical Pediatrics

基　　金：广东省卫生厅科研基金资助项目 (编号 :A1 9973 59)

摘　　要：目的　探讨肾病综合征 (NS)患儿细胞免疫功能和IL 1、IL 6、IL 8及TNFα与NS发病机制的关系。方法　应用流式细胞术和酶联免疫吸附 (ELISA)方法 ,对 2 3例NS患儿在活动期和缓解期 ( 2 1例 )以及 2 0例正常儿童外周血T细胞亚群以及血清和外周血单个核细胞 (PBMC)培养上清诱生IL 1、IL 6、IL 8、TNFα水平进行测定。结果　NS活动期血清和PBMC上清液IL 1、IL 6、IL 8和TNFα水平明显高于缓解期和对照组 ,IL 6和TNFα增高显著 ,缓解期上述细胞因子仍高于对照组。外周血总CD3 +、CD4 +、CD4 +/CD8+细胞比值、CD( 1 6+ 56) +细胞均降低 ,CD8+细胞增高。相关分析发现NS活动期IL 1、IL 6、IL 8和TNFα与CD3 +、CD4 +、CD4 +/CD8+和CD ( 1 6+ 56) +细胞呈负相关 ,与CD8+细胞呈正相关。结论　NS患儿在活动期多种细胞因子失调 ,T细胞亚群的比例结构发生变化 ,细胞免疫功能异常及细胞因子网络失调在NS发病中起一定作用。Objective\ To evaluate the relationship among cellular immunological function,cytokine levels(IL-1,IL-6,IL-8 and TNFα)and pathogenesis of nephritic syndrome(NS) in children with NS.Methods\ Peripheral T cell subset was assayed in 23 active phase NS,21 remission phase and 20 normal children by flow cytometry and their cytokine levels(IL-1,IL-6,IL-8 and TNFα)in serum and supernatant of cultured peripheral blood monocyte(PBMC) were detected by ELISA.Results\ Cytokine levels,especially IL-6 and TNFα in children with active phase NS were significantly higher than those in remission phase and control group,in remission phase higher than in control group.The toltal CD3 + ,CD4 + ,CD(16+56) + and the ratio of CD4 + /CD8 + in peripheral blood decreased,while CD8 + increased.In active phase NS,IL-1,IL-6,IL-8 and TNFα correlated negatively with CD3 + ,CD4 + ,CD(16+56) + and CD4 + /CD8 + ,while positively with CD8 + .Conclusions\ Imbalance of cytokine levels and change of proportion of T cell subset could be detected in children with active phase NS.It was the disturbance of cellular immunological function and imbalance of cytokine network that play a role in the pathogenesis of NS.

关 键 词：肾变病综合征 T细胞亚群 白细胞介素类 肿瘤坏死因子 儿童疾病 NS 

分 类 号：R726.925[医药卫生—儿科]