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目的：观察在慢性肾炎患者外周血中共刺激分子４－１ＢＢ的表达特点及其作用。方法：采用流式细胞仪，对３５例慢性肾炎患者外周血Ｔ淋巴细胞亚群和协同刺激分子４－１ＢＢ的表达进行了研究。结果：活动期慢性肾炎患者Ｔ淋巴细胞亚群明显失衡，表现为ＣＤ４减少，ＣＤ８增加，ＣＤ４／ＣＤ８比值显著降低。缓解期患者Ｔ淋巴细胞亚群失衡得到明显纠正。活动期慢性肾炎患者共刺激分子４－１ＢＢ显著高于正常对照组（４－１ＢＢ表达量为３０．５７±８．１２，比正常人０．７４±０．２８，Ｐ＜０．００１），缓解期患者４－１ＢＢ显著降低，而且４－１ＢＢ异常表达与ＣＤ４＋Ｔ细胞呈负相关（ｒ＝－０．８４，Ｐ＜０．０５）。结论：慢性肾炎中，Ｔ细胞活化所必需的共刺激分子４－１ＢＢ的异常表达可能为慢性肾炎发生和病变进展的免疫因素之一，为深入探讨慢性肾炎的免疫发病机理提供了重要价值。
Objective: To observe the expression of 4-1BB in peripheral blood of patients with chronic nephritis and its role. Methods: The expression of T lymphocyte subsets and co-stimulatory molecules 4-1BB in peripheral blood of 35 patients with chronic nephritis were studied by flow cytometry. Results: T lymphocyte subsets in active chronic glomerulonephritis patients were significantly unbalanced, showing a decrease of CD4, an increase of CD8 and a significant decrease of CD4 / CD8 ratio. The imbalance of T lymphocyte subsets in patients with remission was significantly corrected. The activity of costimulatory molecule 4-1BB in active chronic glomerulonephritis patients was significantly higher than that in normal control group (4-1BB expression was 30.57 ± 8.12, P <0.001 than normal, 0.74 ± 0.28) 4-1BB was significantly decreased in patients with remission, and the abnormal expression of 4-1BB was negatively correlated with CD4 + T cells (r = -0.84, P <0.05). Conclusion: Abnormal expression of co-stimulatory molecule 4-1BB, which is necessary for T cell activation in chronic nephritis, may be one of the immunological factors in the pathogenesis and development of chronic glomerulonephritis, which provides important insight into the pathogenesis of chronic glomerulonephritis.