肾病综合征成人患者细胞免疫和细胞因子的变化及其临床价值-现代医学

肾病综合征成人患者细胞免疫和细胞因子的变化及其临床价值

单位：三亚市人民医院急诊科, 海南三亚 572000

分类号：R692.9

出版年·卷·期（页码）：2020·39·第三期（369-372）

摘要：

目的：探讨肾病综合征（NS）成人患者细胞免疫和细胞因子的变化及其临床价值。方法：选取2015年10月至2017年11月三亚市人民医院收治的76例NS患者为NS组；另选取同时进行健康体检的76例人员为健康组。观察对比两组体内的各项免疫细胞和免疫球蛋白水平、血清细胞因子水平、免疫细胞与细胞因子之间的相关性、白细胞（WBC）以及降钙素原（PCT）水平。结果：NS组的各项免疫细胞水平均低于健康组（P<0.05），IgA、IgE及IgM显著高于健康组（P<0.05），IgG显著低于健康组（P<0.05），各项血清细胞因子水平高于健康组（P<0.05），WBC和PCT水平高于健康组（均r<-0.8，均P<0.05）。NS组体内免疫细胞和细胞因子之间呈负相关（P<0.05）。结论：NS患者因疾病侵袭导致体内的各项免疫细胞水平下降，各血清细胞因子水平升高，两者呈负相关。对患者进行细胞免疫、细胞因子、WBC及PCT检测有助于判断患者疾病的发展情况。

Objective: To investigate the changes and clinical value of cellular immunity and cytokines in adult patients with nephrotic syndrome.Methods: 76 patients with nephrotic syndrome (NS) admitted to our hospital from October 2015 to November 2017 were selected as NS group; 76 patients who were admitted to our hospital for physical examination from October 2015 to November 2017 were selected as control group.Various immune cells and immunoglobulin levels, serum cytokine levels, correlations between immune cells and cytokines,leukocyte(WBC) and procalcitonin(PCT) levels and immunity in the NS group and the control group Globulin levels were observed and compared.Results: The levels of immune cells in the NS group were lower than those in the healthy group (P<0.05); IgA, IgE, and IgM in the NS group were significantly higher than those in the control group (P<0.05); IgG in the NS group was significantly lower than that in the healthy group(P<0.05); the serum cytokine levels in the NS group were higher than those in the healthy group (P<0.05); there was a negative correlation between immune cells and cytokines in the NS group (all r<0.8, P<0.05); The levels of WBCand PCTwere higher than those in the healthy group (P<0.05).Conclusion: In the patients with nephrotic syndrome, the level of immune cells in the body decreases due to disease invasion, and then increases the level of serum cytokines in the body, the two showed a negative correlation in the clinical, therefore, the clinical treatment of nephrotic syndrome patients with cellular immunity, cytokines, WBC and PCT can judge the development of the disease, worthy of application and promotion.

参考文献：

[1] 李文倩,王小蕊,李建平,等.免疫性血小板减少症患者免疫抑制治疗前后免疫细胞亚群及细胞因子谱分析[J].中华内科杂志,2016,55(2):111-115.
[2] 韩斌,韩丽娟.温阳补肾方治疗肾病综合征临床疗效及对免疫的调节作用[J].中华中医药学刊,2017,21(12):3204-3207.
[3] MOTIRAM KAKALIJ R,TEJASWINI G,PATIL M A,et al.Vanillic acid ameliorates cationic bovine serum albumin induced immune complex glomerulonephritis in BALB/c mice[J].Drug Dev Res,2016,77(4):171-179.
[4] 林佳如,樊均明.白细胞介素17在IgA肾病中引起IgA1糖基化异常的作用研究[J].重庆医学,2016,45(28):3907-3909.
[5] PITTET L F,POSFAYBARBE K M,CHEHADE H,et al.Optimizing seroprotection against pneumococcus in children with nephrotic syndrome using the 13-valent pneumococcal conjugate vaccine[J].Vaccine,2016,34(41):4948-4954.
[6] 黄志磊,黄贵心,刘付贞.T淋巴细胞在糖尿病肾病发病机制中的作用[J].广东医学,2017,38(12):1923-1926.
[7] 宋宏颖.慢性阻塞性肺疾病合并肺结核患者免疫功能及其细胞因子水平变化[J].山东医药,2017,57(25):85-87.
[8] WONG E,LASICA M,HE S Z,et al.Nephrotic syndrome as a complication of chronic graft-versus-host disease after allogeneic haemopoietic stem cell transplantation[J].Int Med J,2016,46(6):737-741.
[9] 张洪源,林小堃.高通量血液透析联合尿毒清对老年终末期肾病患者细胞免疫的影响[J].实用医学杂志,2018,17(2):273-276.
[10] 陈昊,冯辉.调节性T细胞在免疫性肾病中的作用及临床应用研究进展[J].免疫学杂志,2017,23(2):179-184.
[11] BOUATOU Y,KOESSLER T,ONISZCZUK J,et al.Nephrotic syndrome in small cell lung cancer and induction of C-Mip in podocytes[J].Am J Kidney Dis,2017,69(3):477-480.
[12] 李庆,宋学君,李志军.糖尿病肾病细胞因子的研究进展[J].中国中西医结合急救杂志,2017,24(1):99-100.
[13] 赵晋红.济肾胶囊调节细胞因子治疗ADR肾病大鼠作用机制的研究[J].中国实验方剂学杂志,2016,13(3):165-169.
[14] ISHIMORI S,INOUE E,SATO M,et al.Examination of clinical relationship between influenza virus vaccine and relapse of nephrotic syndrome in children[J].Pediatr Nephrol,2016,31(10):1760.
[15] 弓玉祥,丁丽红,杨旻宇,等.IgA肾病肾小管间质中淋巴细胞亚群分布及其临床意义探讨[J].东南大学学报(医学版),2015,34(6):876-880.

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