单纯性肾病综合征病儿红细胞免疫功能的变化

①目的探讨单纯性肾病综合征（ＳＮＳ）病儿红细胞免疫功能状态及其临床意义。②方法采用红细胞酵母菌花环法和单克隆抗体间接免疫荧光法，检测了２４例ＳＮＳ病儿活动期和缓解期及３０例健康儿童红细胞Ｃ３ｂ受体花环率（Ｅ－Ｃ３ｂＲＲ）和红细胞免疫复合物花环率（Ｅ－ＩＣＲ）及Ｔ细胞亚群的变化。③结果ＳＮＳ病儿活动期和缓解期Ｅ－Ｃ３ｂＲＲ皆显著低于对照组（ｔ＝８．１６，２．４７，Ｐ＜０．０１，０．０５），活动期明显低于缓解期（ｔ＝４．９５，Ｐ＜０．０１），而Ｅ－ＩＣＲ皆无异常；活动期Ｅ－Ｃ３ｂＲＲ降低与ＣＤ＋４细胞和ＣＤ＋４／ＣＤ＋８比值变化呈正相关（ｒ＝０．４８，０．５３，Ｐ＜０．０１），与ＣＤ＋８细胞变化呈负相关（ｒ＝－０．３６，Ｐ＜０．０５），但与激素治疗反应无相关性；缓解期有反复感染、病情反复或复发倾向者，Ｅ－Ｃ３ｂＲＲ较无上述特征者明显降低（ｔ＝２．３８，２．２５，Ｐ＜０．０５）。④结论ＳＮＳ病儿存在原发性红细胞免疫粘附活性降低，Ｅ－Ｃ３ｂＲＲ降低与其缓解期的易感倾向和病情反复或复发密切相关。

THE CHANGE OF ERYTHROCYTE IMMUNOLOGIC FUNCTION IN SIMPLE NEPHROTIC SYNDROME IN CHILDREN

Objective To discuss the immunologic functional status of erythrocyte in simple nephrotic syndrome(SNS) in children and its clinical significance. Methods The change of erythrocyte C 3b receptor rosette(E C 3bRR), erythrocyte immune complex receptor(E ICR) and T lymphocyte subpopulation in 24 cases of SNS patients in both acute and remission stage and in 30 cases of healthy children were detected by way of erythrocyte yeast rosette and monoclonal antibody indirect immunofluorescence methods. Results The E C 3bRR in both acute and remission stage was significantly lower than that of the control group( t= 8.16, 2.47, P <0.01,0.05). Further more, the E C 3bRR of acute stage was obviously lower than that of the remission stage( t=4.93, P <0.01), while there was no difference in E ICR in all groups. The decrease of E C 3bRR in acute stage had a positive correlation with the CD + 4 cell and the ratio of CD + 4/CD + 8( r=0.48,0.53, P <0.01), and a negative correlation with the change of CD + 8 cell( r=-0.36, P <0.05), but it had no correlation with hormone therapy; E C 3bRR in remission stage was obviously lower in those who had recurrent infections or had a trend to recur than those who had no above characters( t=2.38,2.25, P <0.05). Conclusion There is a decrease in primary erythrocyte immunoadsorbent activity in SNS patients. The decrease of C C 3bRR is closely related to the susceptibility of patients in remission stage, and recurrence of the disease.