肾病综合征患者细胞免疫和细胞因子的变化及其意义

目的探讨肾病综合征（NS）患者T细胞免疫功能和TNF-α与NS发病机制的关系。方法应用流式细胞术和酶联免疫吸附（ELISA）方法，对32例NS患者在活动期和20例缓解期以及18例正常人外周血T细胞亚群以及血清TNF-α水平进行测定。结果血清TNFα水平在活动期明显高于缓解期和对照组，缓解期高于对照组。NS活动期外周血总CD3^＋，CD4^＋，CD4^＋／CD8^＋细胞比值较缓解期和对照组显著降低，CD8^＋细胞增高。NS活动期TNF-α与CD3^＋，CD4^＋，CD4^＋／CD8^＋呈负相关，与CD8^＋细胞呈正相关。结论NS患者在活动期存在细胞因子失调，T细胞亚群的比例结构发生变化，细胞免疫功能异常及细胞因子网络失调在NS发病中起一定作用。

Changes of Cell-mediated Immunity and Cytokines with Nephrotic Syndrome

Objective To evaluate the relationship among cell-mediated immunological function and pathogenesis of nephrotic syndrome（NS）. Methods Peripheral T cell subset was assayed in 32 active phase NS,20 remission phase and 18 control group by flow eytometry and their TNF-α levels in serum were detected by ELISA. Results TNF-α level in active phase NS were significantly higher than those in remission phase anti control group,in remission phase higher than in control group. The total CD3^ ＋ ,CD4 ^＋ and the ratio of CD4^ ＋/ CD8^ ＋ in peripheral blood decreased,while C D8^ ＋ increased. In active phase NS,TNF-α correlated negatively with （CD3^＋ ,CD4 ^＋and CD4^＋ / CD8^＋ , while positively with CD8^＋ ＋ . Conclusion Imbalance of TNF-α and change of proportion of T cell subset couht he detected in patients with active phase NS. It was the disturbance of cell-mediated immunological function and imhalance of cytokines network that play, a role iu the pathogenesis of NS.