原发性肾病综合征与免疫球蛋白的关系研究

目的　探讨原发性肾病综合征患者血中免疫球蛋白的变化及临床意义。方法　采用免疫比浊法对334例原发性肾病综合征患者血中的免疫球蛋白进行测定并比较。结果　①原发性肾病综合征患者免疫球蛋白的变化在性别间无差异(P>0. 05)。②年龄<20岁组的IgA升高者明显高于其他年龄组(P<0. 01),IgG和IgM水平在各年龄组间无差异(P>0. 05)。③血中IgG降低与尿蛋白含量有关,尿蛋白含量越大,其降低越明显。④血中IgG降低与血浆白蛋白有关,血浆白蛋白水平越低,其IgG降低越明显。IgA和IgM在各组间无差异。⑤IgA肾病患者IgA升高的比例明显高于系膜增生性肾炎和膜增生性肾炎(P<0. 01),IgM肾病患者中IgM升高者明显高于IgA肾病和系膜增生性肾小球肾炎患者(P<0. 01);IgG的降低在各组间无差异(P>0. 05)。⑥因感染而复发者血中IgG降低明显高于未复发组(P<0. 05)。结论　原发性肾病综合征患者常存在免疫球蛋白的异常,IgG降低与尿蛋白的多少有关;同时易合并感染。

Relationship between primary nephrotic syndrome and immunoglobulin

Objective To investigate the changes of immunoglobulin in the patients with primary nephrotic syndrome and its clinical significance.Methods Immunoglobulin was detected in 334 patients with nephritic syndrome with immune turbidimetry.Results The changes of immunoglobulin in the patients with nephrotic syndrome did not differ in gender(P>0.05);IgA in the group with age less than 20 was obviously higher than those in other groups with different ages(P<0.01),but there was no difference in IgG and IgM among the different age groups (P>0.05);The decrease of IgG was related with urine protein,which was dependent on the content of urine protein;The decrease of IgG was related with plasma albumin,which was dependent on the contents of albumin,significantly.There was no difference in IgA and IgM among groups;The elevation of IgA in patients with nephropathy was obviously higher than those in the patients with membranoproliferative glomerulonephritis and mesangial proliferative glomerulonephritis(P<0.01),There was no difference in the decrease of IgG among groups(P>0.05);The decrease of IgG in the patients recurred because of infection was higher than that of unrelapse group(P<0.05).Conclusion There is abnormal immunoglobulin level in the patients with primary nephrotic syndrome and the decrease of IgG is related with the content of urine protein,meanwhile the patients are apt to infection.