【摘要】 目的探讨激素抵抗型原发性肾病综合征(SRNS)患者T细胞亚群(CD3+CD4+、CD3+CD8+、CD4/CD8)及Treg(CD4+CD25+highCD127low)的动态变化趋势及临床意义。方法选取初治原发性肾病综合征(PNS)患者65例,标准剂量泼尼松治疗(1 mg·kg-1·d-1)8周后,根据病情缓解与否筛选出SRNS组患者24例。正常对照组30例。患者于治疗前(W0)、治疗4周(W4)、治疗8周(W8)采用流式细胞术检测T细胞亚群及Treg。结果①SRNS组激素治疗8周后,除Alb较治疗前有所升高外(P<0.05),尿蛋白定量、血肌酐(Scr)、尿素氮(BUN)、胆固醇(Cho)、甘油三酯(TG)治疗前后差异无统计学意义(P>0.05)。②SRNS组患者W0与正常对照组比较,CD4%、CD4/CD8升高,而Treg/CD4下降(P<0.05)。SRNS组治疗8周后与治疗前比较,CD4%、CD8%、CD4/CD8、Treg、Treg/CD4差异均无统计学意义(P>0.05)。结论 SRNS患者存在T细胞数量异常,T细胞亚群及Treg/CD4比值失调情况。糖皮质激素治疗8周未能有效改善其临床表现及免疫异常状态。更多还原

【Abstract】 Objective To investigate the change trend of T lymphocyte subsets( CD3+CD4+,CD3+CD8+,CD4 / CD8) and regulatory T cells( Treg,CD4+CD25+ highCD127low) in adult patients with steroid-resistant nephrotic syndrome( SRNS) and its clinical significance.Methods Twenty-four SRNS patients enrolled in SRNS group were chosen from 65 inpatients with primary nephrotic syndrome( PNS) first treated with prednisone( 1 mg·kg- 1·d- 1) for eight weeks,according to the state of clinical remission of PNS.Thirty normal persons were served as healthy control group.T lymphocyte subsets and Treg were detected by flow cytometry before treatment( W0 group),after 4-week treatment( W4 group) and after 8-week treatment( W8 group).Results ①Compared with W0 group,plasma albumin( Alb) increased significantly( P < 0.05),while urinary protein,serum creatinine( Scr),blood urea nitrogen( BUN),cholesterol( Cho) and triglycerides( TG) had no significant differences in W8 group( P > 0.05).②Compared with control group,CD4% and CD4 / CD8 ratio increased significantly,while Treg / CD4 ratio decreased significantly in W0 group( P < 0.05).Compared with W0 group,CD4%,CD8%,CD4 / CD8,Treg and Treg / CD4 had no significant differences in W8 group( P > 0.05).Conclusion There are changes of T cell populations,T lymphocyte subsets and Treg / CD4 ratio imbalance in SRNS adult patients.The clinical manifestation and the disorder immune state even sustained after 8-week treatment of glucocorticoid.更多还原