目的 为了明确免疫细胞对肾小球上皮细胞(glomerular epithelial cell GEC)合成功能的直接作用。方法 应用肾小球细胞体外培养，同位素掺入及放射免疫技术，以总胶原，层粘连蛋白，Ⅲ型前胶原及Ⅳ型胶原的合成为观察指标，动态研究了不同病理类型原发性肾病综合征(INS)患儿外周血单个核细胞(peripheral blood mononuclear cell PBMC)对GEC生物功能的影响。结果 (1)肾病极期未经激素治疗组(未治组)PBMC上清明显促进了GEC合成层粘连蛋白；(2)未治PBMC上清抑制了GEC合成总胶原；(3)未治组PBMC上清促进了Ⅲ型前胶原的合成，而对Ⅳ型胶原的合成无明显影响；(4)肾病患儿PBMC的上述作用与是否足量激素治疗有关，而与尿蛋白能否阴转、肾组织病理类型、肾病临床类型等无直线相关关系。结论 原发性肾病患儿循环免疫细胞可影响GEC合成细胞外基质的功能。免疫细胞的这种活性可被激素治疗改变。

Objective To identify the effect of peripheral blood mononuclear cell(PBMC) on the matrix synthesis of glomerular epithelial cell(GEC). Methods The glomerular cell culture、³ H-prolin incorporation and radioimmunoassay were used to investigate the change of production of collagen, laminin, collagen Ⅲ and collagen Ⅳ by GEC treated by supernatant of PBMC from (1) the children with heavy proteinuria before prednison treatment (nontreatment group); (2) the children with heavy proteinuria after, at least 2 weeks prednison treatment (treatment group); (3) nephrotic children with negative proteinuria (negative group); and (4) normal children. Results (1) the laminin synthesis was significantly improved by PBMC from nontreatment group (P<0.05); (2) the ³ H-prolin incorporation was significantl decrease in the GEC treated by PBMC supernatant from nontreatment group(P<0.05); (3) the supernatant of PBMC from nontreatment group stimulated the collagen Ⅲ synthesis(P<0.05), while, there was no significant difference of collagen Ⅳ synthesis between 4 groups; (4) the activity of PBMC supernatant have no close relation with urinary protein excretion, pathological type and clinical type. Conclusion Factors produced by immune cell from children with idiopathic nephrotic syndrome can regulate the matrix synthesis of cultured rat GEC. Such activities of nephrotic immune cell can be changed by prednison treatment.

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