小剂量肝素对儿童原发性肾病综合征T辅助细胞因子的影响  

Effect of Low Dosage Heparin Calcium on Cytokines Excreted by T Helper Cells of Children with Primary Nephrotic Syndrome

作　　者：康国贵[1] 周江瑾[1] 康友群[1] 丁薇莎[1] 郭立申[1] 

机构地区：[1]浙江省宁波市妇女儿童医院,315012

出　　处：《医学研究通讯》2005年第3期21-23,共3页Bulletin of Medical Research

摘　　要：目的探讨小剂量肝素对原发性肾病综合征(PNS)患儿血清 T 辅助细胞因子的影响。方法 PNS 36例,随机分肝素治疗组(I 组,n=20例)和对照组(Ⅱ组,n=16例),另选25例正常儿童为正常对照组(Ⅲ组,n=25)。PNS 患儿采用泼尼松中长程疗法,Ⅰ组在此基础上给予肝素钙20/kg·d,分2次皮下注射,疗程4周。采用 ELISA 法测定 PNS 患儿用肝素前及肝素后1个月血清 IL-2及 IL-6水平,同时观察用药前后血活化的部分凝血活酶时间(APTT)、D-二聚体(D-D)、血小板和肝功能的变化。结果血清 IL-2水平用药前两组均显著低于正常组;用药后Ⅰ组上升显著高于Ⅱ组,与Ⅲ组比较已无显著差异,Ⅱ组虽有上升,但与用药前比无显著差别,与Ⅲ组比仍在较低水平。血清 IL-6与 IL-2发生相反的改变。用药前两组均显著高于正常组,用药后Ⅰ组下降显著高于Ⅱ组,与正常组比较已无显著差别;Ⅱ组虽有下降,但与正常组比仍在较高水平。小剂量肝素应用后对患儿的血 APTT、D-D、血小板及肝功能无影响,仅个别病例在注射部位出现轻度淤斑,不需处理,均能自行消退。结论小剂量肝素能提高 PNS 患儿血清 IL-2浓度,降低其血清 IL-6水平,对 TH1/TH2细胞有调节作用。Objective Interleukin-2(IL-2)and interleukin-6(IL-6)are excreted by T helper 1 cell and T helper 2 cell respec- tively and pay an important role in pathogenesis of primary nephrotic syndrome(PNS).The aim of the study is to probe the effect of low dosage heparin calcium on serum cytokines-IL-2 and IL-6 of children with PNS.Methods The 36 cases with PNS were divided into two groups- heparin treatment group(Ⅰ group,n=20)and control group(Ⅱ group,n=16).25 normal children were selected as normal group(Ⅲ group,n=25).The scheme of mid-phase prednisone was used in group Ⅰ and group Ⅱ.The 10~u/kg.time of heparin was subcutaneouly in- jected twice a day in group Ⅰ for four weeks.The levels of serum IL-2 and IL-6 were measured by ELISA before and four weeks after treatment in group Ⅰ and group Ⅱ.Activated partial thromboplastin time(APTT),D-dimer(D-D),platelet and hepatic function were measured be- fore and after treatment.Results The serum IL-2 in group Ⅰ and group Ⅱ was much lower than group Ⅲ before treatment,increased much more in group Ⅰ than in group Ⅱ after treatment,no significant different in group Ⅰ comparing with group Ⅲ.However,the serum IL-2 in group Ⅱ was much higher after treatment,no apparent different comparing with before treatment,and significantly lower than in group Ⅲ.The serum IL-6 was much higher before treatment than group Ⅲ,after treatment decreased much more in group Ⅰ than group Ⅱ and was not sig- nificant different comparing with group Ⅲ.However,in group Ⅱ the serum IL-6 decreased,but was still much higher comparing with group Ⅲ .APTT,D-D,platelet and hepatic function were not sigificant different before and after treatment.Conclusion The low dosage heparin can in- crease the level of serum IL-2,decrease the concentration of serum IL-6,and regulate the function of Th1 cells and Th2 cells of PNS.

关 键 词：小剂量肝素 PNS 正常 血清 T辅助细胞因子 原发性肾病综合征 用药 高水平 结论 上升 

分 类 号：R725[医药卫生—儿科] R692[医药卫生—临床医学]