中国实用儿科杂志

中国实用儿科杂志 ›› 2012, Vol. 27 ›› Issue (06): 446-448.

• 论著 • 上一篇    下一篇


槐杞黄颗粒对原发性肾病综合征患儿
免疫状态调节作用研究

戴路露1，2，吴玉斌1 ，吴惠颖２   

  1. 1.中国医科大学附属盛京医院小儿肾脏风湿免疫科，沈阳    110004；2.沈阳市和平区疾病预防控制中心，沈阳    110005
  • 出版日期:2012-06-06 发布日期:2012-05-30

The immune state and regulatory function of Haiqihuang particle in the patients with primary nephrotic syndrome.

  • Online:2012-06-06 Published:2012-05-30

摘要：

目的    观察槐杞黄颗粒辅助治疗原发性肾病综合征（PNS）患儿对淋巴细胞亚群、免疫球蛋白及感染次数的影响。方法    2008-01-01—2009-10-31中国医科大学附属盛京医院小儿肾脏风湿免疫科将住院的101例PNS患儿随机分为A组（62例）和B组（39例），选取正常体检儿童22名为正常对照组。A组采用糖皮质激素联合槐杞黄颗粒治疗，B组单独服用激素。分别于治疗前和治疗3个月、6个月检测患儿的淋巴细胞亚群、免疫球蛋白及记录感染次数、肾病复发次数和药物副反应。结果（1）A、B组治疗前，CD8+高于正常对照组（P＜0.05），CD4+、CD4+/CD8+和 NK细胞均明显降低于正常对照组（P＜0.05），IgA与IgG均低于正常对照组（P＜0.05）。（2）治疗3个月， A组（39例）与B组（30例）之间CD8+细胞差异无统计学意义，两组均明显高于正常对照组，差异有统计学意义（P＜0.01）；B组CD4+及CD4+/CD8+显著低于A组和正常对照组（P＜0.05）；A组与B组NK细胞均高于治疗前，B组低于同期A组（P＜0.05）；IgG明显升高但组间差异无统计学意义。（3）治疗6个月，A组（23例）、B组（9例）间各指标均差异无统计学意义，均低于正常对照组（P＜0.01）。（4）感染次数，A组发生上呼吸道感染6例次，肺炎2例次，肾病综合征复发4例次。B组发生上呼吸道感染10例次，肺炎3例次，泌尿系感染2例次，肾病综合征复发6例次。1例患儿服槐杞黄颗粒后出现较严重腹泻（排除感染性腹泻）。结论    PNS患儿治疗前细胞、体液免疫功能降低、紊乱；槐杞黄颗粒辅助治疗过程中，可能通过提高NK细胞和T辅助淋巴细胞活性，减少感染并有减少肾病综合征复发的趋势，且副反应轻微。

关键词:  , 原发性肾病综合征, 槐杞黄颗粒, 淋巴细胞亚群, 免疫功能

Abstract:

Objective    Observe the effect of Huaiqihuang particles on the lymphocyte populations，immunoglobins and the times of infection of patients with primary nephrotic syndrome（PNS）. Methods    Totally 101 patients first diagnosed with PNS were randomly divided into group A （62 cases） and group B （39 cases）.Group A was treated with prednisone and Huaiqihuang particles，while Group B was treated with prednisone only. Detect the level of lymphocyte populations，immunoglobins，albumin，urine protein before the treatment，3 months and 6 months after treatment. Record the times of infection and relapse of the patient and the side-effect of Haiqihuang particle. A total of 22 healthy children were selected as control group. Results    （1） Before the treatment， the percentage of CD8+ in group A and B was higher than that of the control group（P＜0.05）. However， the percentage of CD4+， NK cell， CD4+/CD8+ and the serum level of IgA and IgG in group A and B were lower than that of the control group（P＜0.05）. （2） After 3 months of treatment， there was no difference in the percentage of CD8+ between group A （n = 39） and group B （n = 30）， but in both groups it was significant ly higher than that of the control group（P＜0.01）. The percentage of CD4+and CD4+/CD8+ in group B was significantly lower than that of group A and control group（P＜0.05）； after 3 months treatment， the percentage of NK cell in group A and B was significantly increased， and in group A was it higher than group B（P＜0.05）. The level of IgG was increased， but there was no difference between the two groups. （3） After 6 months of treatment， there was no difference in every index between group A （n = 23） and group B （n = 9）， but every index in both groups was lower than that of the control group （P < 0.01）. （4） Only one case appeared severe diarrhea. There were 6 cases of upper respiratory tract infection，only 2 cases of pneumonia，and 4 cases of relapse in group A. While， there were 10 cases of upper respiratory tract infection，only 3 cases of pneumonia，2 cases of urinary tract infection，and 6 cases of relapse in group B. Conclusion    The immunity of  patients  with  PNS is abnormal. Huaiqihuang particles can  improve the levels of NK cell and T lymphocyte，hence reduce the times of infection and relapse. Huaiqihuang particles has little side effects.

Key words: primary nephrotic syndrome, Huaiqihuang particles, lymphocyte populations, immune function