Objective To investigate the changes of interleukin 17 (IL-17) and interleukin 23 (IL-23) in adult patients with primary nephrotic syndrome ( PNS) and their roles and clinical significance of IL-17 and IL-23 variations in the occurrence and development of PNS .Methods A total of 35 steroid-effective hospitalized patients with PNS and 20 healthy subjects ( healthy control group ) were enrolled in the study .The patients with PNS were treated with prednisone according to the conventional dose .T cell subsets from peripheral blood and the levels of IL-17,IL-23 and IL-6 from serum and 24 h urine were detected in healthy control group and the patients with PNS before and after treatment .The correlations of 24 h urinary protein quantification with T cell subsets in peripheral blood and the levels of IL -17,IL-23 and IL-6 in both serum and 24 h urine were analyzed ,respectively .Results Compared with healthy control group , the percentage of CD3 +or CD3 +CD4 +cells from patients with PNS significantly decreased (P<0.05), and the levels of IL-17 and IL-6 from serum as well as IL-17, IL-23 and IL-6 from 24 h urine significantly increased(P<0.05).After treatment, the percentage of CD3 +or CD3 +CD4 +cells significantly increased (P<0.05), and the levels of IL-17, IL-23 and IL-6 in 24 h urine significantly decreased (P<0.05).There were positive correlations between 24 h urinary protein quantification and the levels of IL-17 and IL-23 in both serum and 24 h urine respectively (P <0.01). Conclusions IL-17 and IL-23 may contribute to the proteinuria of PNS .Hormone therapy can improve the disorder of cell immune function and the imbalance of T cell subsets .Monitoring the levels of IL-17 and IL-23 in serum and 24 h urine may be helpful for disease judgement and clinical therapy .%目的：观察白细胞介素17（IL－17）和白细胞介素23（IL－23）在成人原发性肾病综合征（PNS）中的变化，探讨其在PNS发生及发展中的作用及临床意义。方法选取初次就诊并激素治疗有效的PNS住院患者35例（实验组），按常规剂量给予强的松治疗；选取同期健康体检者20名作为对照组。检测对照组、PNS患者治疗前和完全缓解时的外周血T细胞亚群及血清和24 h尿液中IL－17、IL－23、白细胞介素6（IL－6）水平，并分别与24 h尿蛋白定量进行相关分析。结果与对照组相比，PNS患者外周血CD3＋、CD3＋CD4＋细胞数减少（P＜0．05），血清IL－17、IL－6和24 h尿液中IL－17、IL－23、IL－6水平明显增加（P＜0．05）；经治疗，PNS患者CD3＋、CD3＋CD4＋细胞数较治疗前明显增加（P＜0．05），24 h尿液中IL－17、IL－23、IL－6水平较治疗前明显降低（P＜0．05）。 PNS患者血清IL－17、IL－23水平和24 h尿液IL－17、IL－23水平均与24 h尿蛋白定量呈显著正相关（P均＜0．01）。结论 IL－17和IL－23可能与PNS患者大量蛋白尿的形成有关；激素治疗能够显著改善PNS患者细胞免疫功能紊乱和T细胞亚群失衡；监测PNS患者血清和24 h尿液中IL－17和IL－23的水平，可能有助于病情的判断和指导临床治疗。
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