肾病综合征患儿免疫球蛋白检测与应用激素的探讨

目的检测原发性肾病患儿IgG、IgA、IgM、IgE、C3水平,探讨肾病患儿对肾上腺皮质激素(泼尼松)的敏感性,了解肾病的发病机制,指导临床治疗。方法分别采用散射比浊法检测血清IgG、IgA、IgM、C3及ELISA法检测血清IgE。结果原发性肾病患儿与正常对照组比较,血清IgA、C3无显著差异,肾病患儿血清IgG水平明显低于正常儿童,IgM、IgE明显高于正常儿童,单纯型与肾炎型肾病结果一致。单纯型与肾炎型肾病对激素治疗敏感性比较有非常显著性差异(x2=18.48 P< 0.005);原发性肾病患儿血清IgE升高组与IgE不升高组对激素治疗的敏感性比较有非常显著性差异(x2=12.46 P< 0.005)。结论原发性肾病综合征患儿存在免疫球蛋白合成异常,可能与患儿体液免疫紊乱有关。而激素治疗敏感性与肾病综合征临床分型及IgE水平高低有关。

Study on Detection of Immunoglobulin and Glucocorticoid Administration in Children with Nephrotic Syndrome

Objective To examine serum levels of IgG, IgA, IgM, IgE and C3 and explore sensitivity of glucocorticoid (prednisone) in primary nephropathyic children to study pathogenesis of primary nephropathy and direct clinical therapy. Methods Examine serum IgG, IgA, IgM and C3 by scattering turbidimetry and IgE by ELISA. Results Compared with healthy children, children suffering from primary nephropathy had lower IgG and higher IgM and IgE, but the same IgA and C3 Simple and nephritic nephropathy had very significant difference in sensitivity of glucocorticoid(x2=18.48 P<0. 005). In primary nephropathy, higher IgE group and normal IgE group were very significantly different in sensitivity of glucocorticoid(x2 = 12 46 P<0. 005). Conclusions Children suffering from primary nephropathy have abnormal immunoglobulin synchesis. that is caused by humoral immunity turbulence. Sensitivity of glucocorticoid is associated with clinical type of nephropathy and IgE level.