IgE和CD23表达水平与儿童原发性肾病综合症相关性的研究

摘要

Objective To explore the correlation between the expressions of IgE and CD23 and primary nephrotic syndrome in children.Methods 52 children with primary nephrotic syndrome and 13 healthy children were recruited into this study.The serum IgE concentrations were detected by immunoradiation assay.The proportion of CD23 positive cells were determined by flow cytometry analysis.Results The IgE concentration and the proportion of CD23+ cells in the children with primary nephrotic syndrome were significantly higher than those of the health counterparts (IgE:[452.5 ± 239.7] vs.[132.6 ± 105.5],P ＜ 0.01; CD23+ cells％:[16.6 ± 7.6] vs.[5.2 ± 3.9],P ＜ 0.05).The serum IgE concentration was obviously higher in the patients with steroid-resistant nephrotic syndrome (SRNS) than in the children with steroid-sensitive nephrotic syndrome (SSNS) before and after the treatment (before the treatment:[462.9 ± 321.2] vs.[382.1 ± 269.0],P ＜ 0.05; after the treatment:[246.7 ± 182.1] vs.[171.7 ± 107.9],P ＜ 0.05).The proportion of CD23+ cells was significantly enhanced in the SRNS children than in the SSNS children before and after the treatment (before the treatment:[19.3 ± 6.4] vs.[15.6 ± 7.7],P ＜ 0.05; after the treatment:[12.2 ± 8.5] vs.[6.1 ± 4.3],P ＜ 0.01).IgE concentration positively correlated with CD23+ proportion in the children with primary nephrotic syndrome (r=0.605,P ＜ 0.05).Conclusions Immune dysfunction was observed in children with primary nephrotic syndrome,as indicated by the abnormal expression of serum IgE concentration and CD23+ cell proportion.Compared to SSNS children,these disorders were more obvious in SRNS children befaore and after treatment.Therefore,a combined testing of serum IgE concentration and CD23+ cell proportion shows great significance in the diagnosis and prognosis evaluation in primary nephrotic syndrome in children.%目的 探讨外周血中IgE和CD23表达水平与儿童原发性肾病综合症的相关性.方法 采用免疫放射法和流式细胞技术检测52例肾病综合症患儿以及13例健康儿童的血清IgE水平和CD23阳性细胞率.结果 肾病综合症患儿的IgE表达水平和CD23阳性细胞率均明显高于对照组的健康儿童,IgE水平:(452.5±239.7) vs.(132.6±105.5),P＜0.01; CD23阳性率:(16.6±7.6)vs.(5.2±3.9),P＜ 0.05,差异具有统计学意义.激素耐药型患儿的IgE的表达水平在治疗前、后均明显高于激素敏感型的患儿,治疗前:(462.9±321.2)vs.(382.1±269.0),P＜0.05;治疗后:(246.7±182.1)vs.(171.7±107.9),P＜0.05.激素耐药型患儿的CD23阳性细胞率在治疗前、后均明显高于激素敏感型的患儿,治疗前:(19.3±6.4)vs.(15.6土7.7),P＜0.05;治疗后:(12.2±8.5)vs.(6.1± 4.3),P＜ 0.01.并且,患儿的IgE水平与CD23阳性率呈正相关(r=0.605,P＜0.05).结论 原发性肾病综合症的患儿血清IgE表达和CD23阳性细胞的免疫功能紊乱,且与激素敏感型患儿相比,激素耐药型患儿的免疫功能紊乱在治疗前、后均更明显.联合检测外周血IgE水平和CD23阳性细胞率在儿童原发性肾病综合症的诊断和预后判断中有重要意义.