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目的:研究原发性肾病综合征患儿初次发病和复发时的血清B细胞活化因子(BAFF)水平,探讨BAFF与儿童肾病综合征体液免疫功能紊乱的相关性。方法:收集2014年1-7月在湖南省儿童医院肾内科住院治疗的54例复发肾病综合征患儿(复发组)、32例初发肾病综合征患儿(初发组)及同期门诊体检的资料完整的21例健康儿童(对照组)的临床资料。采用ELISA法检测血清BAFF的表达水平。结果:复发组、初发组及对照组血清BAFF水平分别为(1.74±1.27)U、(1.73±1.09)U和(4.81±3.57)U,三组比较差异有统计学意义(F=21.963,P<0.01),复发组与初发组比较差异无统计学意义(P>0.05)。血清BAFF水平与IgG水平呈正相关(r=0.371,P<0.01),与IgE呈负相关(r=-0.210,P<0.05),与IgA、IgM、C3、C4无相关性。血清BAFF水平与血清白蛋白水平、24 h尿蛋白总量、尿蛋白定量无相关性(P>0.05)。结论:儿童原发性肾病综合征初发和复发时血清BAFF水平表达均降低,且BAFF的表达水平与IgG、IgE水平相关,BAFF与儿童原发性肾病综合征体液免疫功能紊乱相关。
Objective: To study the serum levels of B-cell activating factor (BAFF) in primary nephrotic syndrome and recurrent children with primary nephrotic syndrome and to explore the relationship between BAFF and humoral immune dysfunction in children with nephrotic syndrome. Methods: 54 children with recurrent nephrotic syndrome (recurrent group) and 32 children with newly diagnosed nephrotic syndrome (initial group) were enrolled in the Department of Nephrology, Children’s Hospital of Hunan Province from January to July 2014. Their physical examinations The complete clinical data of 21 healthy children (control group). Serum BAFF expression levels were detected by ELISA. Results: The serum levels of BAFF in relapsed, primary and control groups were (1.74 ± 1.27) U and (1.73 ± 1.09) U and (4.81 ± 3.57) U, respectively, with significant difference between the three groups (F = 21.963, P <0.01). There was no significant difference between the recurrent group and the initial group (P> 0.05). Serum BAFF level was positively correlated with IgG level (r = 0.371, P <0.01), negatively correlated with IgE (r = -0.210, P <0.05), but not with IgA, IgM, C3 and C4. There was no correlation between serum BAFF level and serum albumin level, 24-hour urine protein and urine protein (P> 0.05). Conclusion: The serum levels of BAFF in children with primary nephrotic syndrome are lower than those in primary nephrotic syndrome. The expression of BAFF is correlated with IgG and IgE levels. BAFF is associated with humoral immune dysfunction in children with primary nephrotic syndrome.