膜性肾病患者临床病理特点及外周血T及Th细胞亚群分析  

Clinicopathological characteristics of membranous nephropathy and analysis of T and Th cell subsets in peripheral blood

作　　者：崔金艳[1] 李洁 CUI Jinyan;LI Jie(Hematonephrology Department,Baoding 072750,Hebei,China;Hemodialysis Room,Baoding SecondCentral Hospital,Baoding 072750,Hebei,China)

机构地区：[1]保定市第二中心医院血液肾病科,河北保定072750 [2]保定市第二中心医院血透室,河北保定072750

出　　处：《中南医学科学杂志》2019年第5期503-507,共5页Medical Science Journal of Central South China

基　　金：保定市科技计划项目(项目编号:18ZF109)

摘　　要：100例膜性肾病患者,根据24 h蛋白尿、血清白蛋白水平分为中高危组78例,低危组22例。另取同期体检的健康志愿者66名为对照组。流式细胞术检测外周血T及Th细胞亚群水平。检测结果显示,间质炎性细胞浸润、肾小管急性病变区在中高危组与低危组之间差异有统计学意义(P<0.05)。膜性肾病患者中IgG4荧光强度最高,IgG2荧光强度最弱。T细胞亚群中中高危组和低危组CD3^+CD45^+、CD3^+CD4^+、CD4^+/CD8^+明显高于对照组(P<0.05)。Th细胞亚群中Th9、Th1、Th2、Th2/Th9在各组间差异有统计学意义(P<0.05);Th9、Th1、Th2水平明显低于对照组,Th2/Th9明显高于对照组(P<0.05)。结果证明,尿蛋白量越大,膜性肾病患者肾脏急性和慢性病变程度越严重;中高危组患者IgG4为主沉淀,低危组患者IgG1为主沉淀;膜性肾病患者外周血T细胞亚群以CD4^+T细胞为主,伴随Th9、Th1、Th2水平明显升高, Th2/Th9值下降。100 patients with membranous nephropathy were divided into high-risk group(78 cases) and low-risk group(22 cases) according to 24-hour proteinuria and serum albumin levels. 66 cases healthy volunteers were selected as control group at the same time. T and Th cell subsets in peripheral blood were detected by flow cytometry. The results showed that there were significant differences in the infiltration of interstitial inflammatory cells and acute tubular lesions between the high-risk group and the low-risk group(P<0.05). Among the patients with membranous nephropathy, IgG4 fluorescence intensity was the highest and IgG2 fluorescence intensity was the weakest. CD3^+CD45^+, CD3^+CD4^+, CD4^+/CD8^+ in high-risk group and low-risk group were significantly higher than those in control group(P<0.05). Th9, Th1, Th2 and Th2/Th9 in Th cell subsets were significantly different among groups(P<0.05). Th9, Th1 and Th2 levels were significantly lower than those in the control group, and Th2/Th9 levels were significantly higher than those in the control group(P<0.05). The results showed that the greater the amount of urinary protein, the more serious the acute and chronic renal lesions in patients with membranous nephropathy;IgG4 was the main precipitation in the high-risk group, IgG1 was the main precipitation in the low-risk group;CD4^+ T cells were the main subsets of peripheral blood T cells in patients with membranous nephropathy, accompanied by a significant increase in Th9, Th1, Th2 levels and a decrease in Th2/Th9 values.

关 键 词：膜性肾病 病理特点 T细胞 TH细胞亚群 

分 类 号：R692[医药卫生—泌尿科学]