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目的 探讨Th1/Th2细胞失衡在原发性肾病综合征（PNS）患儿发病中的作用。方法运用三色荧光标记法流式细胞术检测21例初发和16例缓解期NS患儿外周血Th1和Th2细胞百分率（％）,并以10例正常儿童作对照。结果 正常儿童外周血Th1、Th2和Th0细胞百分率分别为（13.42±4.36）％,（2.53±1.97）％和（1.25±0.92）％。初发的PNS患儿均明显减低,分别为（2.34±2.09）％,（1.02±0.96）％和（0.40±0.38）％（P<0.05）。缓解期PNS患儿,分别为（11.96±4.75）％,（2.87±2.46）％和（1.31±0.87）％,与正常儿童比,差异均无显著性意义。由于初发的PNS患儿Th1细胞减低相对于Th2细胞而言更显著,因而导致Th1/Th2比值也较缓解期PNS患儿和正常儿童明显下降（2.43±2.65比4.17±2.32和5.41±2.77,P均<0.05）。结论 儿童PNS是一种以Th2细胞占优势的免疫介导的肾小球疾病,源于Th1细胞减低所致的Th1/Th2细胞失衡在原发性肾病综合征发病过程中可能起着重要作用。
Objective To investigate the role of Th1 / Th2 cell imbalance in the pathogenesis of children with primary nephrotic syndrome (PNS). Methods The percentage of Th1 and Th2 cells in peripheral blood of 21 infants with initial and 16 remission of NS was detected by the three-color fluorescence-labeled flow cytometry and compared with 10 normal children. Results The percentages of Th1, Th2 and Th0 in normal children were (13.42 ± 4.36)%, (2.53 ± 1.97)% and (1.25 ± 0.92)%, respectively. The incidence of PNS in new onset patients was significantly lower (2.34 ± 2.09)%, (1.02 ± 0.96)% and (0.40 ± 0.38)%, respectively (P <0.05). The PNS children in the remission period were (11.96 ± 4.75)% and (2.87 ± 2.46)%, (1.31 ± 0.87)%, respectively, which were not significantly different from those in normal children. Th1 / Th2 ratio was also significantly lower in PNS children and normal children (2.43 ± 2.65 vs 4.17 ± 2.32 and 5.41 ± 2.77, P <0.05), compared with Th2 cells in newly diagnosed PNS children. P <0.05). Conclusion Children PNS is an immune-mediated glomerular disease predominating in Th2 cells. The imbalance of Th1 / Th2 cells caused by the decrease of Th1 cells may play an important role in the pathogenesis of primary nephrotic syndrome.