目的探讨辅助性T淋巴细胞(Th细胞)亚群紊乱与儿童原发性肾病综合征(PNS)发病的关系。方法选择2000年6月至2005年6月青岛大学医学院附属医院儿科收治的初发PNS患儿35例为研究对象,以15名健康儿童为对照,采用流式细胞术检测35例初发PNS患儿外周血Th细胞亚群,其中22例激素敏感者于缓解期进行复查。结果初发PNS患儿激素治疗前外周血Th1、Th2细胞百分率分别为(7.2±3.6)%和(9.7±4.5)%,与正常对照组[分别为(13.5±5.3)%和(4.5±2.9)%]比较,PNS患儿Th1细胞明显减少而Th2细胞明显增多,PNS组Th1/Th2比值(0.79±1.02)显著低于对照组(3.71±1.92),差异均有统计学意义(P<0.01);激素敏感PNS组治疗前外周血Th1细胞百分率[(6.2±3.9)%]明显低于非激素敏感组[(9.0%±3.1)%](P<0.05),而Th2细胞百分率[(9.9±3.7)%]和Th1/Th2比值(0.70±1.14)与非激素敏感组[分别为(9.4±5.2)%和(0.94±1.06)]比较差异无显著性(P>0.05)。激素敏感组患儿缓解期(隔日疗法6~8周后)与活动期比较,Th1细胞和Th1/Th2比值显著增高而Th2细胞明显下降(P<0.01),而与对照组比较差异均无统计学意义(P>0.05)。结论Th细胞亚群紊乱与儿童PNS的发病关系密切,检测初发PNS患儿外周血Th细胞亚群对预测激素疗效有一定帮助。 Objective To investigate the relationship between the disorder of helper T lymphocyte (Th cell) and the incidence of primary nephrotic syndrome (PNS) in children. Methods From June 2000 to June 2005, 35 cases of newly diagnosed PNS admitted to Pediatric Department of Affiliated Hospital of Qingdao University Medical College were selected as experimental subjects. Fifteen healthy children were used as control. Flow cytometry was used to detect 35 cases of primary PNS Children with peripheral blood Th cell subsets, of which 22 cases of hormone-sensitive remission in the review. Results The percentages of Th1 and Th2 cells in peripheral blood before PNS were (7.2 ± 3.6)% and (9.7 ± 4.5)%, respectively, compared with those in control group [13.5 ± 5.3% and 4.5 ± 2.9 )%], The Th1 cells in PNS children decreased significantly and the Th2 cells increased significantly. The Th1 / Th2 ratio in PNS group (0.79 ± 1.02) was significantly lower than that in control group (3.71 ± 1.92), the difference was statistically significant (P <0.01 ). The percentage of Th1 cells in peripheral blood of hormone-sensitive PNS group before treatment [(6.2 ± 3.9)%] was significantly lower than that in non-hormone sensitive group (9.0% ± 3.1%) (P <0.05) ± 3.7%] and Th1 / Th2 ratio (0.70 ± 1.14) and non-hormone sensitive group [(9.4 ± 5.2)% and (0.94 ± 1.06, respectively]] were not significantly different (P> 0.05). Th1 cells and Th1 / Th2 ratio were significantly increased and Th2 cells were significantly decreased (P <0.01), but there was no statistical difference compared with the control group in the hormone sensitive group at remission (every 6 to 8 weeks after treatment) Significance (P> 0.05). Conclusion The disorder of Th cell subsets is closely related to the pathogenesis of PNS in children. Detecting the Th cell subsets in the peripheral blood of children with PNS may be helpful to predict the effect of hormones.