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目的通过观察原发性肾病综合征(PNS)患儿外周血淋巴细胞亚群,尤其是CD4+CD25+调节性T细胞及CD19+CD23+细胞水平的变化,探讨其免疫发病机制。方法采用双标法用流式细胞仪检测25例初发PNS患儿(PNS组)外周血T淋巴细胞亚群(CD3+、CD3+CD4+、CD3+CD8+、CD4+CD25+)、B淋巴细胞亚群(CD3-CD19+、CD19+CD23+)及自然杀伤细胞(CD3-CD16+56+)水平,同时选取同期19例健康儿童作为健康对照组。数据采用SPSS 15.0软件进行统计学分析。结果 PNS组患儿外周血中CD3+、CD3+CD8+、CD4+CD25+、CD19+CD23+淋巴细胞均显著高于健康对照组(Pa<0.05),而自然杀伤细胞则较健康对照组显著降低(P<0.05);PNS组CD3+CD4+、CD4+/CD8+、CD3-CD19+淋巴细胞与健康对照组比较差异无统计学意义。结论体内淋巴细胞亚群的紊乱参与了PNS的发病过程,其中CD4+CD25+调节性T细胞及CD19+CD23+细胞的变化为PNS的免疫治疗目标提供了理论依据。
Objective To observe the changes of peripheral blood lymphocyte subsets, especially CD4 + CD25 + regulatory T cells and CD19 + CD23 + cells in children with primary nephrotic syndrome (PNS), and to explore the mechanism of the immune pathogenesis. Methods T-lymphocyte subsets (CD3 +, CD3 + CD4 +, CD3 + CD8 +, CD4 + CD25 +) and B lymphocyte subsets in peripheral blood of 25 newly diagnosed PNS children (PNS group) were detected by double- (CD3-CD19 +, CD19 + CD23 +) and natural killer cells (CD3-CD16 + 56 +). Nineteen healthy children in the same period were selected as healthy control group. Data were analyzed by SPSS 15.0 software. Results The levels of CD3 +, CD3 + CD8 +, CD4 + CD25 + and CD19 + CD23 + lymphocytes in peripheral blood of children in PNS group were significantly higher than those in healthy control group (P <0.05), while those in natural killer group were significantly lower than those in healthy control group (P < 0.05). There was no significant difference in PNS between CD3 + CD4 +, CD4 + / CD8 +, CD3-CD19 + lymphocytes and healthy controls. Conclusion The disorder of lymphocyte subsets in vivo is involved in the pathogenesis of PNS. The changes of CD4 + CD25 + regulatory T cells and CD19 + CD23 + cells provide the theoretical basis for the immunotherapy of PNS.