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目的探讨激素不同疗效的原发性肾病综合征(PNS)患儿外周血P选择素(CD62P)和细胞表面糖蛋白(CD44)质量浓度及临床意义。方法将2005-03—2005-08在中山大学附属第一医院儿童肾病中心住院的PNS患儿54例,患儿分为激素敏感活动期(19例)、激素敏感缓解期(13例)、激素耐药活动期(12例)和激素耐药缓解期(10例)4组。另设20名年龄、性别相匹配的健康儿童为正常对照组。采用放射免疫法(RIA)和酶联免疫吸附法(ELISA)分别测定各组血浆CD62P和血清CD44质量浓度,并分析其与患儿24h尿蛋白定量、血清白蛋白(ALB)、胆固醇(CHOL)、尿素氮(BUN)和肌酐(Cr)之间的相关关系。结果(1)PNS激素敏感患儿,其活动期外周血CD62P及CD44质量浓度均显著高于缓解期(P<0·01)。(2)激素耐药患儿,其活动期血清CD44质量浓度显著高于缓解期(P<0·05),而血浆CD62P质量浓度差异无显著性意义(P>0·05)。(3)PNS活动期患儿外周血CD62P、CD44质量浓度与24h尿蛋白定量及CHOL呈正相关,与ALB呈负相关。结论CD62P及CD44与儿童PNS的发生发展密切相关;动态检测PNS患儿外周血中CD62P和CD44的水平,可作为判断PNS病情和疗效的指标。
Objective To investigate the levels of P-selectin (CD62P) and cell surface glycoprotein (CD44) in children with primary nephrotic syndrome (PNS) with different therapeutic effects of hormones and their clinical significance. Methods From March 2005 to August 2005, 54 children with PNS were enrolled in the Children’s Nephropathy Center of the First Affiliated Hospital of Sun Yat-sen University. The children were divided into three groups: hormone sensitive period (19 cases), hormone sensitive period (13 cases) Resistance active period (12 cases) and hormone resistance remission (10 cases) 4 groups. Another set of 20 age, gender-matched healthy children as the normal control group. The levels of CD62P and CD44 were measured by radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA), and the levels of 24 h urinary protein, serum albumin (ALB), cholesterol (CHOL) , Urea nitrogen (BUN) and creatinine (Cr) between the correlation. Results (1) In children with PNS, the levels of CD62P and CD44 in peripheral blood were significantly higher than those in remission (P <0.01). (2) The level of serum CD44 in active drug-resistant children was significantly higher than that in remission (P <0.05), but there was no significant difference in plasma CD62P levels (P> 0.05). (3) The levels of CD62P and CD44 in peripheral blood of children with PNS were positively correlated with 24-hour urinary protein and CHOL, but negatively correlated with ALB. Conclusions CD62P and CD44 are closely related to the occurrence and development of PNS in children. The dynamic detection of CD62P and CD44 in the peripheral blood of children with PNS can be used as an index to judge the severity and effect of PNS.