Immune Function And Clinical And Pathological Relationship In Children With Primary Nephrotic Syndrome

Objective:By summarization and analysis of humoral immunity and complement levels in children with primary nephrotic syndrome(PNS),the correlation between serum immunoglobulin and complement levels and clinical manifestations and renal pathology in children was investigated,so as to provide reference for clinical doctors’ diagnosis and treatment.Methods:Choice of January 1,2011 on December 31,2020 in the first affiliated hospital of nanchang university hospital treatment,age < 18 parallel kidney biopsy centesis of children,a total of 81 cases children with clinical and pathological data information collection(general information,clinical data,laboratory data,the types of renal pathology),the analysis were retrospectively summarized respectively,SPSS21.0statistical software was used to process the data.Results:(1)The serum Ig G level of male children with PNS was significantly lower than that of female children(P < 0.05),while the level of C4 was higher than that of female children(P < 0.05).There was no statistical significance in serum Ig A,Ig M and complement C3 levels between male and female children(P > 0.05).(2)There was no significant difference in serum Ig G,Ig A,Ig M,C3 and C4 levels among different age groups(P > 0.05).(3)The serum Ig G level of serum albumin < 15g/L group was significantly lower than that of serum albumin 15 ～ 20g/L group and serum albumin > 20g/L group.The serum Ig G level of serum albumin 15 ～ 20g/L group was significantly lower than that of serum albumin > 20g/L group.At the same time,the C4 level of serum albumin > 20g/L group was lower than that of serum albumin 15-20 g /L group and serum albumin < 15g/L group,and the differences among all the above groups were statistically significant(P < 0.05).There were no significant differences in C4 levels between the albumin 15-20 g/L group and the albumin < 15g/L group(P > 0.05),and there were no significant differences in serum Ig A,Ig M and complement C3 among all groups(P> 0.05).(4)There were no significant differences in serum Ig G,Ig A,Ig M,C3 and C4 levels among different 24 h urinary protein quantification groups(P > 0.05).(5)The serum Ig G,C3 and C4 levels were significantly different among the pathological types(P < 0.05).The serum Ig G levels in the FSGS group were significantly lower than those in the MCD group,Ig AN group,MSPGN group and MN group,and the serum Ig G levels in the MCD group were lower than those in the Ig AN group.The levels of C3 in MCD and MSPGN groups were higher than those in MN and FSGS groups.The level of complement C4 in MN group was lower than that in MCD group,and the differences among all the above groups were statistically significant(P< 0.05),while the differences among other groups were not statistically significant(P> 0.05).(6)There were significant differences in serum Ig A,C3 and C4 levels among different immunofluorescence types(P < 0.05).The serum Ig A levels of Ig A dominant type and Ig M+ complement type were higher than those of Ig M dominant type,Ig G+complement type and Ig G+A+M+ complement type.Secondly,the C3 level of Ig A+complementarity type was lower than that of Ig A+ complementarity type,Ig M+complementarity type,Ig M+ complementarity type and no immune complex type.The C3 level of Ig G+A+M+ complement type was lower than that of Ig A-dominant type,Ig M-dominant type and no immune complex type.The C3 level of Ig G+complement type was lower than that of Ig M dominant type and non-immune concordant type.Finally,the C4 level of Ig G+ complement type was lower than that of Ig M+ complement type,Ig A+ complement type,Ig M+ complement type and no immune complex type.The C4 level of Ig A+ complement type was lower than that of Ig M+ complement type and Ig M+ complement type,and the C4 level of Ig G+A+M+complement type was lower than that of Ig M+ complement type.There were statistically significant differences among all the above groups(P < 0.05),while there were no statistically significant differences among the remaining groups(P > 0.05).(7)There was no significant difference in serum Ig G,Ig A,Ig M,C3 and C4 levels between the infected group and the non-infected group(P > 0.05).Conclusion:1.The serum Ig G level of male children with PNS was significantly lower than that of female children,while the level of C4 was higher than that of female children,suggesting that the immune status of children with PNS was different between different genders.2.The lower the level of serum Ig G and plasma albumin in children with PNS,the more serious the hypoalbuminemia is,and clinical attention should be paid to the condition of the children in time;3.The serum Ig G level of PNS children diagnosed with pathological type FSGS was lower than that of other pathological type groups,suggesting that the pathological type of children with significantly reduced serum Ig G level was more likely to be FSGS;4.At present,the pathological types of children with PNS are still mainly MCD type,and the majority of immunofluorescence types are Ig M type.5.There was no significant correlation between serum Ig G,Ig A,Ig M,C3 and C4 levels and age,24-hour urinary protein,or infection.