扁桃体摘除术对IgA肾病患者外周血CD4^＋CD25^＋细胞数及病情的影响

【目的】观察扁桃体摘除对IgA肾病（IgAN）患者外周血CD4^＋CD25^＋细胞数的影响。【方法】研究对象包括37例IgAN病人（A组）及37例非肾炎慢性扁桃体炎病人（B组），10例正常人（C组）。对A、B两组实施扁桃体摘除术，观察手术前及摘除后1、3个月外周血CD4^＋CD23^＋细胞比例。收集IgAN病人的尿液，检测24h尿蛋白，尿红细胞。【结果】A组CD4^＋CD25^＋细胞数显著低于B、C两组（P均〈0．05），后两组之间无显著差异（P〉0．05）；A组术后1个月为1．32％±0．313％，3月为3．01％±0．310％，术后1个月与B组及C组有明显差剐（P均〈0．05），术后3个月与B组及C组无显著差别（P均〉0．05）。A组术后1个月及3个月，血尿及蛋白尿均较术前明显减少；随着血尿、蛋白尿逐渐减少而外周血CD4^＋CD25^＋细胞数逐渐恢复正常水平。【结论】扁桃体切除术可改善IgAN患者免疫功能。

Effect of Tonsillectomy on Expression of Peripheral Blood CD4+ CD25+ in Patients with IgA Nephropathy

Objective] To observe the number of CD4^- CD25^＋ cells of peripheral blood before and after tonsillectomy in IgA nephropathy （IgAN） and to investigate their clinical significance. Methods] Thirty sev- en patients with IgAN, 37 patients without renal disease and 10 normal human were studied. The CD4^＋ CD25^＋ cells were examined by flow cytometry method. 24h urine samples were collected to determine the protein and red blood cell concentrations. Urine protein concentrations were measured by the Coomassie Blue binding rea- gent. Urine erythrocytes were determined by urinary sediment. Results]CD4^＋ CD25^＋ cells significantly decreased in IgAN patients compared to the patients without renal disease and normal human before and 1 month after tonsillectomy （1.15±0. 213）% vs （2. 95±0.534）%, P〈0. 05,（1.15±0. 213）%vs （2. 78±0. 454）%,P〈0.05, （1.32±0.313）% vs （2. 95±0. 534）%, P〈0.05）,and （1.32%±0.313%） vs （2.78±0. 454）%, P〈0.05], but there was no statistically significant difference between 3 months after tonsillectomy and the control group（3.01±0.310）% vs （2.95±0.534）%, p〉0.05, and （3.01±0. 310）% vs （2.78±0. 454）%, P〉0.05]. At 1 month or 3 month after tonsillectomy, urine protein and urine erythrocytes signifi cantly decreased. Decreased CD4^＋CD25^＋ cells in peripheral blood in IgAN gradually got normal when urine protein and urine erythrocytes gradually decreased. Conclusion] The number of CD4^＋ CD25^＋ ceils in peripheral blood in IgAN may reflect patient＇s condition and therapeutic effect.