首页> 中文期刊> 《重庆医学》 >免疫球蛋白及C3对儿童原发性肾病综合征病情评估及预后的意义

免疫球蛋白及C3对儿童原发性肾病综合征病情评估及预后的意义

         

摘要

Objective To understand the clinical significance of serum immunoglobulins and C3 at the initial episode on the treat-ment and prognosis of childhood primary nephrotic syndrome(PNS) .Methods 426 children patients with first episode of PNS ad-mitted to the nephrology department of our hospital from January 1 ,2003 to December 30 ,2012 were retrospectively analyzed .The clinical data were collected for conducting the analysis on the immuneglobulins and C 3 levels in different age groups ,clinical classifi-cation ,hormone response ,recurrence ,prognosis and correlation among various pathological types .Results (1)Compared with the healthy children ,the peripheral blood IgG level in childhood PNS was significantly decreased ,while the IgM and IgE level were sig-nificantly increased .(2)The IgE level in steroid-sensitive nephrotic syndrome(SSNS) was higher than that in steroid-resistant ne-phrotic syndrome(SRNS);which in frequent recurrence nephrotic syndrome was higher than that in non-recurrence nephrotic syn-drome .(3) The C3 level in the PNS children patients aged over 1 years and nephritis nephrotic syndrome(NNS) was lower than that in simple nephrotic syndrome(SNS) .Conclusion PNS is correlated with the immune dysfunction .Serum IgE level increase clinically manifests by the steroid sensitivity and frequent relapse ;the lower the C3 level ,the poorer the prognosis .%目的:了解儿童原发性肾病综合征(PNS )初次发病时血清免疫球蛋白、C3水平及其在治疗预后中的临床意义。方法回顾性分析2003年1月1日至2012年12月30日首次发病就诊的426例 PNS 患儿不同年龄段免疫球蛋白、C3水平及与临床分型、激素反应、复发情况、预后、各病理类型间的相关性。结果(1)与健康儿童相比,PNS患儿外周血IgG水平明显降低, IgM、IgE水平明显升高。(2)激素敏感型肾病(SSNS)的IgE水平高于激素耐药型肾病(SRNS);频复发患儿的IgE水平高于未复发。(3)>1岁的PNS患儿,肾炎型肾病(NNS)的C3水平低于单纯型肾病(SNS)。结论 PNS 和免疫功能紊乱有关,血清 IgE水平增高,临床上多表现为激素敏感及频复发;血清 C3水平越低,患儿预后越差。

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