儿童过敏性紫癜与特异性免疫研究  

A study on relationship between specific immunity and Henoch-Schonlein purpura in children

作　　者：黄燕萍[1] 吴红艳[1] 杨永民 杨周岐[1] 赵文静[1] 孙艳[1] 

机构地区：[1]西安交通大学医学院第一医院儿科,陕西西安710061 [2]陕西省长安区妇幼保健院儿科,陕西西安710010

出　　处：《中国妇幼健康研究》2009年第6期621-622,667,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨特异性免疫与过敏性紫癜的关系，以明确特异性免疫在过敏性紫癜发病机制中的作用，并通过对过敏性紫癜、过敏性紫癜伴肾脏损害患儿的血清补体（c3）、T细胞亚群和免疫球蛋白水平进行对比分析，以了解其是否在发病机制上存在差异。方法将96例未接受过糖皮质激素及其他免疫抑制治疗的初次入院的过敏性紫癜患儿分为单纯性过敏性紫癜组和紫癜性肾炎组，对81例患儿检测其T细胞亚群（cD3、CD4、CD8、CD4／CD8）、96例患儿检测血清补体（C3）和体液免疫（IgG、IgA）、92例患儿检测特异性IgE、过敏原。结果过敏性紫癜组患儿血清IgG水平9．94±2．60g／L明显高于紫癜性肾炎组的7．32±3．61g／L，t=-3．897，P〈0．001；过敏性紫癜组c3、CD3、CIM均值及CD4／CD8比值高于紫癜性肾炎组，IgA、CD8均值低于紫癜性肾炎组，但经比较差异无显著性；血清总IgE阳性率为96．74％，最常见的致敏原是律草（16．30％），其次是鱼（14．13％）和黄瓜／芹菜（13．04％）。结论免疫功能紊乱与过敏性紫癜发病可能存在某种联系；过敏性紫癜患儿需对相应过敏原做好有效地预防。Objective To explore relationship between specific immunity and Henoch-Schonlein purpura （HSP） in children so as to determine role of specific immunity in pathogenesis of HSP, and to investigate difference in pathogenesis between HSP and HSP associated with nephritis （HSPN） by contrasting serum levels of complements, T cell subsets （ CD3, CIM, CD8, CD4/CD8） and immunoglobulin （IG）. Methods 96 children with HSP who primarily admitted to our hospital and didn＇ t receive any glucocorticoids therapy and other immnnosupressants therapy were selected and divided into two groups：simple HSP group and HSPN group according to whether the child was associated with nephritis. The serum levels of T cell subsets （ CD3, CD4, CD8, CD4/CD8 ） of 81 children, the serum levels of complement（C3） and immunoglobulin（ IgG and IgA） of all 96 children and specific IgE and allergen of 92 children in the two groups were detected. Results The serum levels of IgG of children in HSP group（9.94 ±2.60g/L） were significantly higher than children in HSPN group（7.32 ± 3.61g/L） （t = -3. 897, P 〈 0. 001 ）. The serum levels of C3, CD3, CD4 and ratio of CD4/CD8 of children in HSP group were higher than HSPN group, and the serum levels of IgA and CD4 of children in HSP group were lower than HSPN group, but there were no significant differences between the two groups. The total positive rate of srum IgE was 96.74% and the most common allergen for specific IgE was Herba Humuli（ 16.30% ）, the next was fish（ 14.13% ） and cucumber/celery（ 13.04% ）. Conclusion The immunologic functional disorder might be associated with HSP in children. For those children with HSP, corresponding allergens found should be prevented effectively.

关 键 词：过敏性紫癜 T细胞亚群 补体 免疫球蛋白 过敏原 

分 类 号：R72[医药卫生—儿科]