中华临床免疫和变态反应杂志2016，Vol.10Issue(4)：351-356,6.DOI:10.3969/j.issn.1673-8705.2016.04.007
肾病综合征患儿血清细胞因子水平及T细胞亚群变化的临床意义
Clinical Significance of Serum Cytokines-level and T Cell Subsets in Children with Primary Nephrotic Syndrome
摘要
Abstract
Objective The association between the expression profile of Th 1/Th2 cytokines & T lymphocyte subtypes and clinical guidance in children with primary nephrotic syndrome ( PNS) was evaluated in pres-ent study .Methods From October 2011 to July 2015 , 184 children with PNS in the department of nephrology of Children's Hospital of Zhejiang University School of Medicine were recruited .The serum concentrations of IL-2, IL-6, IL-10, IFN-γand T lymphocyte subtypes such as CD 3 +, CD4 +, CD8 +lymphocytes and CD4/CD8 ratio were evaluated in 67 steroid sensitive nephrotic syndrome (SSNS) chil-dren without frequent relapses, 67 SSNS with frequent relapses (FRNS), 50 patients with steroid-resist-ant nephrotic syndrome ( SRNS ) and 60 healthy children , respectively .Results ( 1 ) Compared with the control group and the NFR-SSNS group, the plasma levels of IL-10 in the FR-SSNS group and the SRNS group were higher [ (2.81 ±0.81) ng/L, (3.68 ±1.37) ng/L vs.(7.64 ±5.99) ng/L, (6.40 ± 6.45) ng/L], the difference was significant, P<0.001.The case number with IL-10≥5 ng/L in FRNS was more than the cases from SSNS without frequent relapses (40/67 vs.9/67), P<0.001.The ROC curve of IL-10 showed that IL-10≥5 ng/L had predictive value in FRNS patients ( AUC=0.736 , sensi-tivity 59.7%, specificity 85.1%) .( 2 ) Plasma IL-6 level was highest in the SRNS group , higher than the other two SSNS groups, P<0.05.(3) Compared with the control group, the plasma IL-2 and IFN-γlevels were significantly lower in case groups , P <0.05 .( 4 ) The value of CD4 + T lymphocytes in NFR-SSNS was higher than the other three groups respectively , the difference was significant , P<0.05 . Conclusions The high plasma levels of IL-10 can predict the onset of proteinuria continuance/recur-rence in children with PNS .IL-10≥5 ng/L might play an important role in predicting frequent relapse in children with SSNS .The results from present study implies that Th 1/Th2 cytokines&T lymphocyte sub-types is associate with immune dysfunction in children with primary nephrotic syndrome , and play a role in the pathogenesis of PNS .关键词
肾病综合征/儿童/T淋巴细胞/白细胞介素10Key words
nephrotic syndrome/children/T lymphocytes/interleukin-10分类
医药卫生引用本文复制引用
童科珍,毛建华,傅海东,沈辉君,刘爱民..肾病综合征患儿血清细胞因子水平及T细胞亚群变化的临床意义[J].中华临床免疫和变态反应杂志,2016,10(4):351-356,6.基金项目
国家自然科学基金（81270792，81470939，81170664），十二五科技支撑计划-儿童遗传性肾脏疾病的分子分型体系的建立及示范推广（2012BAI03B02），浙江省自然基金（LH14H050002），浙江省医药卫生科技创新项目 （）
