ԭ���������ۺ�������ѪPѡ���غ�ϸ�������ǵ��ײⶨ�����ٴ�����

目的探讨激素不同疗效的原发性肾病综合征(PNS)患儿外周血P选择素(CD62P)和细胞表面糖蛋白(CD44)质量浓度及临床意义。方法将2005-03—2005-08在中山大学附属第一医院儿童肾病中心住院的PNS患儿54例,患儿分为激素敏感活动期(19例)、激素敏感缓解期(13例)、激素耐药活动期(12例)和激素耐药缓解期(10例)4组。另设20名年龄、性别相匹配的健康儿童为正常对照组。采用放射免疫法(RIA)和酶联免疫吸附法(ELISA)分别测定各组血浆CD62P和血清CD44质量浓度,并分析其与患儿24h尿蛋白定量、血清白蛋白(ALB)、胆固醇(CHOL)、尿素氮(BUN)和肌酐(Cr)之间的相关关系。结果(1)PNS激素敏感患儿,其活动期外周血CD62P及CD44质量浓度均显著高于缓解期(P<0·01)。(2)激素耐药患儿,其活动期血清CD44质量浓度显著高于缓解期(P<0·05),而血浆CD62P质量浓度差异无显著性意义(P>0·05)。(3)PNS活动期患儿外周血CD62P、CD44质量浓度与24h尿蛋白定量及CHOL呈正相关,与ALB呈负相关。结论CD62P及CD44与儿童PNS的发生发展密切相关;动态检测PNS患儿外周血中CD62P和CD44的水平,可作为判断PNS病情和疗效的指标。

Levels and clinical significance of CD62P and CD44 in blood of children with primary nephritic syndrome

Objective To probe the levels and clinical significance of CD62P and CD44 in children with primary nephritic syndrome (PNS).Methods Totally 54 children were divided into four groups,steroid-sensitive NS at active stage(19 patients),and at remission stage(13 patients),steroid-resistance at active stage (12 patients) and at remission stage(10 patients).The levels of plasma CD62P and serum CD44 were assayed by radioimmunoassay (RIA) and enzyme linked immunoabsorbant assay (ELISA) in each group and in 20 normal age and sex-matched controls,and its correlation with 24-hour proteinuria,serum albumin,cholesterol,urea nitrogen and creatinine were also analyzed.Results (1) In the steroid-sensitive patients,the levels of CD62P and CD44 in patients at active stage were much higher than those of in patients at remission stage (P<0.01).(2) In the steroid-resistant patients,the levels of CD44 in patients at active stage were higher than that in patients at remission stage (P<0.05),but there were no statistical significant differences between the level of serum CD62P in patients at active stage and that in patients at remission stage (P>0.05).(3) The levels of CD62P and CD44 in PNS children at active stage were positively correlated with that of 24-hour proteinuria and serum cholesterol,and negatively correlated with serum albumin.Conclusion The levels of serum CD62P and CD44 are related to the development and progression of children with PNS,and could be used to estimate the state and the remedial effect of children with PNS.