原发性肾病综合征患者外周血Th9及IL—9的变化及临床意义

任金来等

[摘要] 目的 研究原发性肾病综合征（primary nephrotic syndrome，PNS）患者外周血中辅助性T细胞9（Th9）的含量及其效应分子白细胞介素（IL-9）的表达情况，探讨Th9及IL-9与PNS临床指标的相关性及可能的免疫学机制。 方法 收集35例PNS患者和30名健康对照者。用流式细胞仪检测PNS患者和健康对照者外周血中的Th9细胞在CD4+T细胞中的比例；酶联免疫吸附试验（ELISA）检测PNS患者及健康对照者血浆中IL-9的水平。采用t检验和Spearman秩相关分析进行统计学分析。结果 PNS患者外周血中Th9细胞的比例明显高于健康对照组差异有统计学意义[分别为（1.06±0.20）%，（0.26±0.07）%，P<0.05]。PNS患者外周血IL-9水平高于健康对照组差异有统计学意义[分别为（70.02±13.66） pg/mL，（18.77±5.35） pg/ml，P<0.05]。PNS患者外周血Th9细胞的表达与24 h尿蛋白、胆固醇、甘油三酯、尿素氮及IL-9的水平呈正相关，与血清白蛋白、IgG水平呈负相关；PNS患者IL-9的水平与24 h尿蛋白、胆固醇、甘油三酯、尿素氮的水平呈正相关，与血清白蛋白、IgG、C3水平呈负相关。结论 PNS患者外周血Th9细胞比例及血浆中lL-9水平显著升高，且与相关临床指标明显相关，提示Th9及IL-9可能在PNS的发病过程中发挥重要作用。

[关键词] 原发性肾病综合征；辅助性T细胞9；白细胞介素9

[中图分类号] R392.1 [文献标识码] A [文章编号] 1674-0742（2015）06（c）-0006-04

[Abstract] Objective To detect the concentration of T helper cells 9（Th9） and the expression of its effector molecule interleukin（IL-9） in the peripheral blood of primary nephrotic syndrome（PNS） patients， and analyze the relationship of Th9 and IL-9 with the clinical indexes of PNS and their possible role in the immunological pathogenesis of PNS. Methods Thirty-five patients with PNS and 30 healthy controls were included. Th9 cells were obtained from PNS patients and healthy controls and detected by flow cytometry. The levels of IL-9 in PNS patients and healthy controls were detected by ELISA tests. T-test and Spearmans correlation were used for statistical analysis. Results The expression of Th9 in the peripheral blood of PNS patients was significantly higher than normal controls [（1.06±0.20）% vs （0.26±0.07）%]， P<0.05. Meanwhile， the level of IL-9 in the peripheral blood of PNS patients was significantly higher than normal controls [（70.02±13.66） vs （18.77±5.35）]pg/ml， P<0.05. The expression of Th9 was positively correlated with 24-hour urinary protein， cholesterol， triglyceride， blood urea nitrogen， the level of IL-9 respectively， while that of Th9 cells was inversely proportional to serum albumin， immunoglobulin G respectively. The level of IL-9 was positively correlated with 24-hour urinary protein， cholesterol， triglyceride， blood urea nitrogen respectively， and the level of IL-9 was inversely proportional to serum albumin， immunoglobulin G， C3 respectively. Conclusion The expression of Th9 and level of IL-9 in the peripheral blood of PNS patients increase significantly， and which are related with the relative clinical indicators， these indicate that the abnormality of Th9 and IL-9 may play an important role in the pathogenesis of PNS.