儿童肾病综合征中免疫球蛋白G和M水平：埃及两个中心的研究
Immunoglobulin G and M levels in childhood nephrotic syndrome: two centers Egyptian study.
作者信息
El Mashad Ghada Mohamed, El Hady Ibrahim Soha Abd, Abdelnaby Sameh Abd Allah
机构信息
Assistant Professor of Pediatrics, Faculty of Medicine, Menoufia University, Egypt.
Assistant Professor of Pediatrics, Faculty of Medicine, Benha University, Egypt.
出版信息
Electron Physician. 2017 Feb 25;9(2):3728-3732. doi: 10.19082/3728. eCollection 2017 Feb.
INTRODUCTION
Idiopathic nephrotic syndrome (INS) is the most common glomerular disease in children. Immune cell subsets may play a role in pathogenesis of INS. We aimed to assess immunoglobulin G (IgG) and immunoglobulin M (IgM) levels in children with nephrotic syndrome (NS) to predict prognosis of the disease and response to treatment.
METHODS
This prospective case control study was done in Pediatric Nephrology Units at Minoufia and Benha University Hospitals, during the period from 1st March 2014 to 30th June 2015. Seventy-five children in the active stage of INS and 75 apparently healthy children of matched age and sex were included in this study. Statistical evaluation was performed by SPSS version 18.0 using independent-samples t-test, Chi-square, and Pearson's correlation coefficient (r).
RESULTS
Compared with healthy children, IgM level was high, IgG level and IgG/IgM ratio were low (p≤0.05). The IgG level and IgG/IgM ratio decreased more in FRNS than in IFRNS group, and was the lowest in SRNS group. The IgM level increased more in FRNS than in IFRNS group, and was the highest in SRNS group (p<0.05, respectively).
CONCLUSIONS
Our findings support the idea that IgG level has a prognostic value in NS in children.
引言
特发性肾病综合征（INS）是儿童最常见的肾小球疾病。免疫细胞亚群可能在INS的发病机制中起作用。我们旨在评估肾病综合征（NS）患儿的免疫球蛋白G（IgG）和免疫球蛋白M（IgM）水平，以预测疾病预后和对治疗的反应。
方法
这项前瞻性病例对照研究于2014年3月1日至2015年6月30日期间在米努菲亚大学医院和本哈大学医院的儿科肾脏病科进行。本研究纳入了75名处于INS活动期的儿童和75名年龄和性别匹配的明显健康儿童。使用SPSS 18.0版本通过独立样本t检验、卡方检验和皮尔逊相关系数（r）进行统计学评估。
结果
与健康儿童相比，IgM水平较高，IgG水平和IgG/IgM比值较低（p≤0.05）。频繁复发型肾病综合征（FRNS）组的IgG水平和IgG/IgM比值下降幅度大于激素敏感型肾病综合征（IFRNS）组，且在激素耐药型肾病综合征（SRNS）组中最低。FRNS组的IgM水平升高幅度大于IFRNS组，且在SRNS组中最高（p均<0.05）。
结论
我们的研究结果支持IgG水平对儿童NS具有预后价值这一观点。
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