肾病综合征患儿细胞免疫和细胞因子的变化及其意义

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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 investigate the relationship between the cellular immune function and the pathogenesis of nephrotic syndrome (NS) in children with NS, IL 1, IL 6, IL 8 and TNFα. Methods Flow cytometry and enzyme-linked immunosorbent assay (ELISA) were used to detect T lymphocyte subsets and serum and peripheral blood in peripheral blood of 23 NS children during active and remission (21 cases) and 20 normal children Blood mononuclear cells (PBMC) culture supernatant induced IL 1, IL 6, IL 8, TNFα levels were measured. Results The levels of IL-1, IL-6, IL-8 and TNF-alpha in NS active stage supernatant and PBMC supernatant were significantly higher than those in remission and control group. IL 6 and TNFα were significantly higher in remission stage and higher in remission stage than those in control group. The ratio of total CD3 +, CD4 + and CD4 + / CD8 + in peripheral blood decreased, CD (1 6+ 56) + cells decreased and CD8 + cells increased. Correlation analysis showed that IL 1, IL 6, IL 8 and TNFα were negatively correlated with CD3 +, CD4 +, CD4 + / CD8 + and CD (16+ 56) + cells in NS and positively correlated with CD8 + cells. Conclusion In children with NS, many cytokines are imbalanced during the active phase, the proportion of T cell subsets is changed, and abnormal cellular immunity and cytokine network disorders play a role in the pathogenesis of NS.
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