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目的 探讨外周血单个核细胞 (PBMC)呼吸道病毒感染与糖皮质激素敏感型单纯性肾病综合征 (SSNS)的发生和反复的关系。方法 采用免疫组化、原位杂交、酶联免疫吸附和病毒分离技术 ,对青岛大学医学院附属医院儿科和滨州医学院附属医院 2 0 0 0年 1月至 2 0 0 2年 12月收治的 36例初发组、15例反复组和 2 1例缓解组SSNS患儿检测了PBMC病毒分子表达和血清中病毒特异性IgM抗体水平。结果 初发组与反复组比较 ,PBMC中呼吸道合胞病毒抗原和肠道病毒基因表达的阳性率差异均无显著性 ;而初发组与缓解组和对照组比较及反复组与缓解组和对照组比较 ,PBMC中两种病毒感染的阳性率差异均有显著性 (P <0 0 5 ,P <0 0 1)。初发组与其他各组比较 ,不同病毒的特异性IgM抗体阳性率明显增高 ( P <0 0 5 ) ;而反复组与缓解组和对照组比较 ,多种病毒的特异性IgM抗体的阳性率差异均无显著性。 结论 初发和反复SSNS患儿的PBMC均易被病毒感染 ,糖皮质激素的应用并不影响细胞内病毒抗原和基因的表达 ,但可使病毒特异性IgM抗体的产生明显减少 ;PBMC内病毒抗原或基因表达阳性可做为SSNS有反复倾向的重要分子标志之一。
Objective To investigate the relationship between respiratory virus infection of peripheral blood mononuclear cells (PBMCs) and the occurrence and recurrence of glucocorticoid-sensitive simple nephrotic syndrome (SSNS). Methods Immunohistochemistry, in situ hybridization, enzyme-linked immunosorbent assay (ELISA) and virus isolation were used to analyze the clinical data of patients admitted to the Affiliated Hospital of Qingdao University Medical College and the Affiliated Hospital of Binzhou Medical College from January 2000 to December 2002 36 cases of initial group, 15 cases of repeated group and 21 cases of SSNS children with remission group were detected PBMC virus molecule expression and serum levels of virus-specific IgM antibodies. Results There were no significant differences in the positive rates of respiratory syncytial virus antigen and enterovirus expression in PBMC between the initial group and the repeated group, while the difference between the initial group and the remission group and the control group and between the repeated group and the remission group and the control group There was significant difference in the positive rates of PBMC infection between the two viruses (P <0.05, P <0.01). Compared with other groups, the positive rate of specific IgM antibodies of different viruses was significantly increased in the initial group (P <0.05), while the positive rate of specific IgM antibodies of multiple viruses in the repeated group compared with the remission group and the control group There was no significant difference. CONCLUSIONS: The PBMC of infants with initial and repeated SSNS are susceptible to virus infection. The application of glucocorticoid does not affect the expression of viral antigens and genes in cells, but it can significantly reduce the production of virus-specific IgM antibodies. The expression of viral antigens Or positive gene expression can be used as SSNS one of the important molecular markers of repeated tendencies.