激素治疗对原发性肾病综合征患儿淋巴细胞亚群及免疫因子的影响

doi:10.20223/j.cnki.1000-8535.2025.08.013

广州医药 ›› 2025, Vol. 56 ›› Issue (8): 1103-1108.DOI: 10.20223/j.cnki.1000-8535.2025.08.013

激素治疗对原发性肾病综合征患儿淋巴细胞亚群及免疫因子的影响

荆俊鹏¹, 覃婉元², 王军龙¹, 荣成智¹, 胡雪桦¹

1 广西壮族自治区妇幼保健院检验科（广西南宁 530000）
2 广西医学科学院-广西壮族自治区人民医院检验科（广西南宁 530000）

收稿日期:2024-07-05 出版日期:2025-08-20 发布日期:2025-09-17
通讯作者: 胡雪桦,E-mail：919898331@qq.com
基金资助:
广西壮族自治区卫生厅自筹经费科研课题（Z20200744）

Effects of steroid therapy on lymphocyte subsets and immune factors in children with primary nephrotic syndrome

JING Junpeng¹, QIN Wanyuan², WANG Junlong¹, RONG Chengzhi¹, HU Xuehua¹

1 Department of Medical Laboratory,Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China
2 Department of Medical Laboratory,Guangxi Academy of Medical Sciences,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China

Received:2024-07-05 Online:2025-08-20 Published:2025-09-17

摘要/Abstract

摘要： 目的分析原发性肾病综合征（PNS）患儿在糖皮质激素（激素）治疗后淋巴细胞亚群及免疫因子的水平变化,以探讨PNS耐药机制。方法选取PNS患儿共71例,正常对照组108例,收集PNS患者在激素治疗前、后及正常对照组儿童的淋巴细胞亚群[CD4⁺、CD8⁺、CD4⁺/CD8⁺、CD19⁺和自然杀伤（NK）细胞]及免疫因子水平,并分析激素治疗后激素敏感患儿和激素耐药患儿相关指标的差异。结果 PNS患儿淋巴细胞亚群及免疫因子水平异常,激素治疗后PNS患儿总免疫球蛋白E（IgE）水平[767.50（270.25,1 937.50）IU/mL vs 311.00（62.70,757.00）IU/mL]（P=0.008）下降,而CD4⁺T细胞比例[（33.88±7.42）% vs（38.25±7.16）%]（P=0.004）升高,激素治疗敏感患儿NK细胞比例高于激素治疗耐药患儿[（8.39±4.60）% vs（4.72±1.99）%]（P=0.034）,IgE水平低于耐药患儿[311.00（62.70,633.00）IU/mL vs 783.00（88.05,1 290.00）IU/mL]（P<0.001）。结论 PNS患儿淋巴细胞亚群分布及免疫球蛋白水平异常,激素治疗可影响患儿CD4⁺T细胞比例及IgE水平,并且NK细胞比例和IgE水平与患儿激素耐药相关。

关键词: 肾病综合征, 淋巴细胞亚群, CD4⁺T细胞, 自然杀伤细胞, 免疫球蛋白E

Abstract: Objective To evaluate the changes of lymphocyte subsets and immune factors levels in children with primary nephrotic syndrome（PNS）,and explore the pathogenesis of PNS．Methods A total of 71 patients with PNS and 108 normal control cases were selected．Flow cytometry was used to detect the concentration of lymphocyte subsets（CD4⁺,CD8⁺,CD4⁺/CD8⁺,CD19⁺ and natural killer[NK] cells）and immune factors before and after treatment．The difference of related factors between steroid-sensitive and steroid-resistant children after therapy were analyzed．Results Lymphocyte subsets and immune molecule levels were abnormal in children with NPS．The level of IgE（767.50[270.25,1 937.50]IU/mL vs 311.00[62.70,757.00]IU/mL,P=0.008）was significantly decreased after therapy（P<0.05）,while CD4⁺ T cells（[33.88±7.42]% vs[38.25±7.16]%,P=0.004）were significantly increased．The level of NK cells in steroid-sensitive children was significantly higher than that in steroid-resistant children（[8.39±4.60]% vs[4.72±1.99]%,P=0.034）,while the level of IgE was significantly lower than that of steroid -resistant children（311.00[62.70,633.00]IU/mL vs 783.00[88.05,1 290.00]IU/mL,P<0.001）．Conclusions The distribution of lymphocyte subsets and the level of immune factors in PNS children were abnormal．Steroid therapy could affect the levels of CD4⁺ T cells and IgE,and the levels of NK cells and IgE were related to steroid-resistance in PNS children．

Key words: primary nephrotic syndrome, lymphocyte subsets, CD4⁺ T cells, natural killer cells, immune globulin E

荆俊鹏, 覃婉元, 王军龙, 荣成智, 胡雪桦. 激素治疗对原发性肾病综合征患儿淋巴细胞亚群及免疫因子的影响[J]. 广州医药, 2025, 56(8): 1103-1108.

JING Junpeng, QIN Wanyuan, WANG Junlong, RONG Chengzhi, HU Xuehua. Effects of steroid therapy on lymphocyte subsets and immune factors in children with primary nephrotic syndrome[J]. Guangzhou Medical Journal, 2025, 56(8): 1103-1108.

参考文献

[1] RODRIGUEZ-BALLESTAS E,REID-ADAM J.Nephrotic syndrome[J].Pediatr Rev,2022,43(2):87-99.
[2] WANG C S,GREENBAUM L A.Nephrotic syndrome[J].Pediatr Clin North Am,2019,66(1):73-85.
[3] COLUCCI M,CORPETTI G,EMMA F,et al.Immunology of idiopathic nephrotic syndrome[J].Pediatr Nephrol,2018,33(4):573-584.
[4] CHEN J,QIAO X H,MAO J H.Immunopathogenesis of idiopathic nephrotic syndrome in children:Two sides of the coin[J].World J Pediatr,2021,17(2):115-122.
[5] 解艳欢. 原发性肾病综合征免疫发病机制研究[J].医学信息,2023,36(20):189-192.
[6] 刘宇萌,安东.淋巴细胞亚群检测在肾病综合征患儿免疫功能评价中的意义[J].中华全科医学,2022,20(4):661-664,672.
[7] NOONE D G,IIJIMA K,PAREKH R.Idiopathic nephrotic syndrome in children[J].Lancet,2018,392(10141):61-74.
[8] 寿晓霞,刘佳谊.淋巴细胞亚群、hs-CRP、TGF-β1水平与儿童原发性肾病综合征预后的关系研究[J].国际检验医学杂志,2020,41(12):1479-1482.
[9] LAMA G,LUONGO I,TIRINO G,et al.T-lymphocyte populations and cytokines in childhood nephrotic syndrome[J].Am J Kidney Dis,2002,39(5):958-965.
[10] KEMPER M J,ZEPF K,KLAASSEN I,et al.Changes of lymphocyte populations in pediatric steroid -sensitive nephrotic syndrome are more pronounced in remission than in relapse[J].Am J Nephrol,2005,25(2):132-137.
[11] 郑文炼,王小祥,陈文涛,等.严重烧伤后免疫细胞功能变化和炎症反应之间关系的研究进展[J].广州医药,2023,54(10):1-11.
[12] CHEN W,CAI J,RAFFETSEDER U,et al.Association between high NK-Cell count and remission of primary membranous nephropathy:A retrospective chart review and pilot study[J].Clin Ther,2023,45(4):364-374.
[13] 周晖登,黄海锋,唐银琳,等.NK细胞对激素敏感型肾病综合征患儿预后判断的价值[J].现代免疫学,2019,39(1):41-44.
[14] CYSTER J G,ALLEN C D C.B cell responses:Cell interaction dynamics and decisions[J].Cell, 2019,177(3):524-540.
[15] DOMEIER P P,RAHMAN Z S M,ZIEGLER S F.B cell- and T cell-intrinsic regulation of germinal centers by thymic stromal lymphopoietin signaling[J].Sci Immunol,2023,8(79):eadd9413.
[16] PONTICELLI C,LOCATELLI F.Glucocorticoids in the treatment of glomerular diseases:Pitfalls and pearls[J].Clin J Am Soc Nephrol,2018,13(5):815-822.
[17] 庄亚飞,程巾,吴琛,等.儿童原发性肾病综合征SOCS3表达与糖皮质激素耐药的相关性研究[J].临床儿科杂志,2024,42(5):414-418.
[18] GUO H L,LI L,XU Z Y,et al.Steroid-resistant nephrotic syndrome in children:A mini-review on genetic mechanisms,predictive biomarkers and pharmacotherapy strategies[J].Curr Pharm Des,2021,27(2):319-329.
[19] AHMADIAN E,RAHBAR SAADAT Y,DALIR ABDOLAHINIA E,et al.The role of cytokines in nephrotic syndrome[J].Mediators Inflamm,2022(2022):6499668.
[20] 黄佳斯,何宇婷,陈瑶,等.基因多态性对儿童肾病综合征糖皮质激素治疗效果的影响[J].分子诊断与治疗杂志,2022,14(9):1459-1463.
[21] 代莉,张玉江,刘继维,等.激素耐药型肾病综合征基因研究现状及进展[J].临床内科杂志,2021,38(10):716-718.
[22] MCDONNELL J M,DHALIWAL B,SUTTON B J,et al.IgE,IgE receptors and anti-IgE biologics:Protein structures and mechanisms of action[J].Annu Rev Immunol,2023,41(2023):255-275.
[23] 陈广道,刘运可,王亚曙,等.喀什地区和广州地区过敏性疾病儿童过敏原IgE阳性率比较[J].广州医药,2021,52(4):123-126.
[24] 何学慧,傅桐,王秀丽,等.儿童原发性肾病综合征激素敏感型与特应性疾病的关系[J].中华临床免疫和变态反应杂志,2021,15(5):521-527.
[25] HADHRI A,MRABET S,BEN AICHA N,et al.Nephrotic syndrome with minimal change disease and atopy in NorthAfrican adults[J].Tunis Med,2023,101(2):253-258.
[26] YESMIN A,HOSSAIN M A,ISLAM M N,et al.Comparative study of serum IgE level in frequent relapse and infrequent relapse nephrotic syndrome in children[J].Mymensingh Med J,2023,32(1):22-27.

激素治疗对原发性肾病综合征患儿淋巴细胞亚群及免疫因子的影响

Effects of steroid therapy on lymphocyte subsets and immune factors in children with primary nephrotic syndrome

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 7

编辑推荐

Metrics

本文评价

[1]	刘冰, 许惠丽, 王敏芳. 淋巴细胞亚群在鉴别低增生性骨髓增生异常综合征和再生障碍性贫血中的价值[J]. 广州医药, 2025, 56(5): 689-693.
[2]	周思诗, 梁鹏, 张丽敏. 类风湿因子、T淋巴细胞亚群与类风湿关节炎病情程度的关系研究[J]. 广州医药, 2025, 56(3): 361-365.
[3]	于雅丽. IL-33、IL-37、NLRP3及NK/DC比值与慢性乙型肝炎患者病情相关性研究[J]. 广州医药, 2023, 54(10): 52-57.
[4]	李俊. 补阳还五汤加减治疗肾病综合征的疗效及临床价值[J]. 广州医药, 2022, 53(2): 48-51.
[5]	方雅秀, 郑东, 谭燕, 周晓明, 陈国华, 章慧, 郭彩凤. 免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者T淋巴细胞亚群、免疫球蛋白、IL-6和CXC13水平影响[J]. 广州医药, 2021, 52(2): 84-88.
[6]	邱明瑜, 于力, 王丽娜. ACE2基因多态性与儿童激素敏感型肾病综合征复发的关系[J]. 广州医药, 2018, 49(2): 6-9.
[7]	刘元春, 郝志宏, 于力. 儿童肾病综合征红细胞分布宽度与肾功能损害的相关分析[J]. 广州医药, 2016, 47(3): 49-52.