激素敏感型肾病综合征患儿NK细胞水平对预后的评估价值  

Evaluative value of NK cell level for the prognosis of children with steroid-sensitive nephrotic syndrome

作　　者：王登莲 李治成 官晓艳[1] 林元涛 WANG Denglian;LI Zhicheng;GUAN Xiaoyan;LIN Yuantao(Department of Pediatrics,the First People′s Hospital of Zigong,Sichuan Zigong 643000,China;Department of Nephrology,the First People′s Hospital of Zigong,Sichuan Zigong 643000,China)

机构地区：[1]自贡市第一人民医院儿科,四川自贡643000 [2]自贡市第一人民医院肾病内科,四川自贡643000

出　　处：《中国妇幼健康研究》2021年第10期1463-1468,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨激素敏感型肾病综合征(SSNS)患儿自然杀伤(NK)细胞水平对预后的评估价值。方法回顾性分析2017年9月到2020年9月在自贡市第一人民医院接受治疗的120例SSNS患儿的临床资料,经常规口服泼尼松片治疗后,根据预后情况将其分为预后良好组(n=76)和预后不良组(n=44),比较两组的临床资料,并利用受试者工作曲线(ROC)分析首次治疗蛋白转阴时间、NK细胞水平预测患儿预后的价值,采用Logistic回归分析引起SSNS患儿预后不良的危险因素。结果预后不良组初发年龄<7岁、频繁复发、病程≥6个月、呼吸道感染的比例及首次治疗蛋白转阴时间均明显高于预后良好组,NK细胞水平明显低于预后良好组,差异均有统计学意义(t值分别为4.878、4.415、6.154、8.366、3.861、3.228,P<0.05)。经ROC分析,首次治疗蛋白转阴时间、NK细胞水平预测SSNS患儿预后不良的曲线下面积分别为0.757、0.826。初发年龄<7岁(OR=2.234,95%CI:1.146~4.355)、频繁复发(OR=3.248,95%CI:1.156~9.126)、病程≥6个月(OR=5.215,95%CI:1.154~12.567)、呼吸道感染(OR=4.851,95%CI:1.235~19.054)、首次治疗蛋白转阴时间≥10.740天(OR=3.957,95%CI:1.125~13.918)、NK细胞水平<13.320%(OR=2.871,95%CI:1.186~6.950)均是引起SSNS患儿预后不良的危险因素(P<0.05)。结论NK细胞水平评估SSNS患儿预后有较高价值;此外,初发年龄、复发情况、病程、呼吸道感染情况、首次蛋白转阴时间也应成为临床密切关注的指标。Objective To study the evaluative value of natural killer(NK)cell level for the prognosis of children with steroid-sensitive nephrotic syndrome(SSNS).Methods The clinical data of 120 children with SSNS and treated in the First People′s Hospital of Zigong from September 2017 to September 2020 were retrospectively analyzed.After the regular treatment of oral prednisone tablets,they were divided into the good prognosis group(n=76)and the poor prognosis group(n=44)according to the prognostic condition.The clinical data of the two groups were compared.Receiver operating characteristic(ROC)curve was used to analyze the values of time of protein turning negative at the first treatment and NK cell level in predicting the prognosis of children.Logistic regression was used to analyze the risk factors of poor prognosis of children with SSNS.Results In the poor prognosis group,initial onset age<7 years old,frequent recurrence,course of disease≥6 months,proportion of respiratory tract infection and time of protein turning negative at the first treatment were significantly higher than those in the good prognosis group,NK cell level was significantly lower than that in the good prognosis group,and the differences were statistically significant(t=4.878,4.415,6.154,8.366,3.861 and 3.228,respectively,P<0.05).ROC analysis showed that the area under the curve of time of protein turning negative at the first treatment and NK cell level for predicting the poor prognosis of children with SSNS were 0.757 and 0.826,respectively.Initial onset age<7 years old(OR=2.234,95%CI:1.146-4.355),frequent recurrence(OR=3.248,95%CI:1.156-9.126),course of disease≥6 months(OR=5.215,95%CI:1.154-12.567),respiratory tract infection(OR=4.851,95%CI:1.235-19.054),time of protein turning negative at the first treatment≥10.740 d(OR=3.957,95%CI:1.125-13.918)and NK cell level<13.320%(OR=2.871,95%CI:1.186-6.950)were the risk factors of poor prognosis of children with SSNS(P<0.05).Conclusion NK cell level has high value in assessing the prognosis of childr

关 键 词：儿童 激素敏感型肾病综合征 自然杀伤细胞 激素治疗 泼尼松片 

分 类 号：R726.9[医药卫生—儿科]