非典型记忆B细胞在频繁复发肾病综合征患儿中的研究  

Atypical memory B cells in children with frequently relapsing nephrotic syndrome

作　　者：杨婷 袁文君 李娜娜 孙瑞 庄亚飞 程巾 关凤军 YANG Ting;YUAN Wenjun;LI Nana;SUN Rui;ZHUANG Yafei;CHENG Jin;GUAN Fengjun(Department of Pediatrics,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院儿科,江苏徐州221000

出　　处：《国际检验医学杂志》2024年第19期2415-2419,共5页International Journal of Laboratory Medicine

摘　　要：目的观察频繁复发肾病综合征(FRNS)患儿外周血中非典型记忆B细胞的分布变化。方法选取2020年10月至2023年3月该院收治的原发性肾病综合征(PNS)患儿60例为研究对象,根据对糖皮质激素(GC)反应分为非频繁复发肾病综合征(NFRNS)组(25例)和FRNS组(35例)。另选取年龄、性别匹配的健康儿童20例为对照组。比较各组GC治疗前后非典型记忆B细胞的变化,并与各临床数据作相关性分析。结果GC治疗前,FRNS组和NFRNS组总B细胞(CD19^(+)CD20^(+))、总记忆B细胞(CD19^(+)CD20^(+)CD27^(+))、静息记忆B细胞(CD19^(+)CD20^(+)CD21^(+)CD27^(+))和非典型记忆B细胞(CD19^(+)CD20^(+)CD21-CD27-)比例均较对照组升高,且FRNS组较NFRNS组升高明显(P<0.05)。GC治疗后,FRNS组和NFRNS组总B细胞、总记忆B细胞、静息记忆B细胞、激活记忆B细胞(CD19^(+)CD20^(+)CD21-CD27^(+))和非典型记忆B细胞比例较同组治疗前降低(P<0.05);FRNS组非典型记忆B细胞比例较NFRNS组和对照组升高(P<0.05)。GC治疗前,FRNS组和NFRNS组24 h尿蛋白定量较对照组升高,免疫球蛋白G、白蛋白水平较对照组降低,且FRNS组24 h尿蛋白定量明显高于NFRNS组(P<0.05)。GC治疗前,FRNS组24 h尿蛋白定量与非典型记忆B细胞比例呈正相关(P<0.05)。结论FRNS患儿外周血存在非典型记忆B细胞异常分布;非典型记忆B细胞升高可作为FRNS患儿在GC治疗后复发的标志。Objective To observe the distribution of atypical memory B cells in peripheral blood of children with frequently relapsing nephrotic syndrome(FRNS).Methods A total of 60 children with primary nephrotic syndrome(PNS)admitted to the hospital from October 2020 to March 2023 were selected as the research objects.According to the response to glucocorticoid(GC),they were divided into non-frequently relapsing nephrotic syndrome(NFRNS)group(25 cases)and FRNS group(35 cases).A total of 20 age-and gender-matched healthy children were enrolled as the control group.The changes of atypical memory B cells in each group before and after GC treatment were compared,and the correlation between the changes and clinical data was analyzed.Results Before GC treatment,The percentages of total B cells(CD19^(+)CD20^(+)),total memory B cells(CD19^(+)CD20^(+)CD27^(+)),resting memory B cells(CD19^(+)CD20^(+)CD21^(+)CD27^(+))and atypical memory B cells(CD19^(+)CD20^(+)CD21-CD27-)in FRNS group and NFRNS group were significantly higher than those in control group.And the FRNS group was significantly higher than the NFRNS group(P<0.05).After GC treatment,the percentages of total B cells,total memory B cells,resting memory B cells,activated memory B cells(CD19^(+)CD20^(+)CD21-CD27^(+))and atypical memory B cells in FRNS group and NFRNS group were lower than those before GC treatment(P<0.05).The FRNS group had a significantly higher proportion of atypical memory B cells than the NFRNS group and the control group(P<0.05).Before GC treatment,the 24 h urinary protein in FRNS group and NFRNS group were higher than those in control group,and the levels of immunoglobulin G and albumin were lower than those in control group.The 24 h urinary protein in FRNS group was significantly higher than that in NFRNS group(P<0.05).Before GC treatment,there was a positive correlation between 24 h urinary protein and the proportion of atypical memory B cells in FRNS group(P<0.05).Conclusion There is abnormal distribution of atypical memory B cells in peripheral blood

关 键 词：频繁复发 肾病综合征 非典型记忆B细胞 儿童 

分 类 号：R692.6[医药卫生—泌尿科学]