摘要
目的检测原发性肾病综合征（ primary nephrotic syndrome, PNS ）患儿不同时间点尿液中单核细胞趋化蛋白．1（MCP-1）及IL-18的含量，探讨其与PNS的发生、发展、反复及预后有无相关性。方法选取65例初发PNS患儿为研究对象，根据对激素效应及随访结果分为三组：激素敏感型。肾病综合征（ steroid-sensitive NS, SSNS） 35例，激素耐药型肾病综合征（ steroid-resistant NS, SRNS） 15例，频反复肾病综合征（ frequent-relapse NS, FRNS） 15例。另取20例健康体检儿童作为正常对照组。分别在发病初期未用糖皮质激素时、足量激素治疗8周时、足量激素治疗16周或病情反复时采集外周血标本及尿标本。采用ELISA法检测患儿不同时间点尿液中单核细胞趋化蛋白-1（MCP-1）及IL-18的水平，并采用全自动生化分析仪测定PNS患儿不同时间点血尿素氮、肌酐及24h尿蛋白定量。结果（1）SSNS组治疗前、治疗后8周尿IL-18水平均高于对照组[治疗前（160．30±27．29）pg／ml，治疗后（157．62±26．85）pg／ml，对照组（70．88±14．43）pg／ml]；治疗16周后MCP-1、IL-18水平显著低于治疗前、治疗后8周[治疗16周（20．98±4．53）pg／ml，（79．09±7．23）pg／ml，P〈0．05]。（2）SRNS组治疗前尿MCP-1及IL-18水平显著高于SSNS组治疗前与对照组[SRNS组治疗前（76．84±5．58）pg／ml，（252．37±25．34）pg／ml，P〈0．05]，但与治疗后8周比较差异无统计学意义[治疗8周（72．32±4．30）pg／ml，（243．70±35．43）pg／ml，P〉0．05]，当联合免疫抑制剂环磷酰胺治疗16周后则显著低于治疗前、治疗后8周[治疗16周（34．03±2．56）pg／ml，（114．42±21．33）pg／ml，P均〈0．05]。（3）FRNS组治疗前、治疗后8周尿MCP-1及IL-18水平与SSNS组比较差异无统计学意义[FRNS组治疗前（30．43±4．61）pg／ml，（156．65±34．39）pg／ml，治疗8周（29．41±4．76）pg／
Objective To investigate the concentration of monocyte chemoattractant protein -1 （ MCP-1 ） and interleukin-18 （IL-18） in the urinary of children with primary nephrotie syndrome（PNS） at different time points, and to explore their correlation with occurrence, development, progression, and prog- nosis of PNS. Methods A total of 65 pediatric cases from our hospital was enrolled in this study, and was divided into three groups based on the retrospective the follow-up results including steroid-sensitive NS （SSNS） （ n = 35）, steroid-resistant NS （SRNS） （ n = 15 ）, and frequent-relapse NS （FRNS） （ n = 15） groups. Another 20 heahhy children served as normal controls. Peripheral blood samples and urine speci-men were collected at three time points （ without glucocorticoids, treatment after 8 weeks, and treatment after 16 weeks or recurrence）. The levels of MCP-1 and IL-18 in the llrine were assayed by enzyme-linked immu- nosorbent assay （ELISA）. The levels of blood urea nitrogen, creatinine, and 24-hour urinary protein excre- tion were assayed by full-automatic biochemical study appliance. Results （Din SSNS group, the levels of urinary IL-18 before treatment and treated for 8 weeks were higher than the normal control group [ before treatment ： （ 160. 30 ± 27.29 ） pg/ml ; treated for 8 weeks ： （ 157.62 ± 26. 85 ） pg/ml ; normal control group ： （70. 88 ± 14.43 ） pg/ml ]. However, after treated for 16 weeks, the levels of urinary MCP-1 and IL-18 were markedly decreased compared with that of control group and those before treatment and treated for 8 weeks [treated for 16 weeks： （20. 98 ±4. 53） pg/ml,and （79. 09 ±7.23） pg/ml, P 〈0. 05]. （2）In SRNS group, the levels of urinary MCP-1 and IL-18 before treatment were remarkably higher than that of control group and that of SSNS group before treatment[ SSNS group before treatment： （76. 84 ± 5.58 ）pg/ml, and （252. 37 ± 25.34） pg/ml, P 〈 0.05 ], but no significant difference was found w
出处
《中国医师杂志》
CAS
2013年第5期621-625,共5页
Journal of Chinese Physician
