血液灌流治疗重症过敏性紫癜17例疗效分析  

Efficacy of hemoperfusion for treatment of severe Henoch-Schonlein purpura in 17 patients

作　　者：周红霞[1,2] 梅柏如[1,2] 赵丽萍[1,2] 葛婷婷[1,2] 张林[1,2] 

机构地区：[1]南京医科大学附属无锡市人民医院 [2]无锡市儿童医院儿童肾脏风湿免疫科,江苏无锡214000

出　　处：《临床儿科杂志》2012年第4期336-338,共3页Journal of Clinical Pediatrics

摘　　要：目的观察血液灌流辅助治疗重症过敏性紫癜的疗效。方法将重症过敏性紫癜患儿37例随机分为对照组(20例)、治疗组(17例)。对照组患儿采用常规治疗(抗炎、抗过敏、抗凝及对症处理),治疗组患儿在常规治疗基础上加用血液灌流,两组患儿均治疗10 d。比较两组患儿治疗前后的临床症状及T细胞亚群、血清IgA、IL-6、IL-8、尿微量白蛋白、尿视黄醇结合蛋白(RBP)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)。结果治疗组患儿腹痛及血便、皮疹、肉眼血尿等临床症状改善时间均较对照组缩短(P<0.05);CD3、CD4、CD4/CD8较对照组高,而IL-8较对照组低(P均<0.05);尿微量白蛋白、尿RBP、NAG较对照组低(P<0.05)。结论血液灌流是辅助治疗重症过敏性紫癜的一种有效的新方法,可能通过免疫调节、清除血液中的炎症递质来缓解临床症状、减轻肾损伤。Objective To observe the clinical efficacy of hemoperfusion for treatment of severe Henoch-Schonlein purpura.Methods From January 2008 to May 2011,37 pediatric patients with severe Henoch-Schonlein purpura were enrolled and randomly divided into control group（20 cases）and treatment group（17 cases）.The patients in control group were treated with conventional treatment（anti-inflammatory,antianaphylaxis,anticoagulation,symptomatic treatment）,and the patients in treatment group were treated with conventional treatment plus hemoperfusion.All patients were treated for 10 days.The clinical symptoms,T cell subsets,serum IgA,IL-6,IL-8,urinary albumin,retinol binding protein（RBP）,and N-acetyl-beta-D-glucosaminidase（NAG）were compared between two groups.Results The time taken to improve of severe Henoch-Schonlein purpura related symptoms such as abdominal pain,bloody stool,rash and hematuria in therapy group was shorter than in control group（P 0.05）.The levels of CD3,CD4 and CD4/CD8 were elevated significantly in treatment group than those in control group（P 0.05）.The level of IL-8 were reduced significantly in treatment group than that in control group（P 0.05）.The levels of microal-buminuria,retinol binding protein and N-acetyl-β-D-glucosaminidase in urine were reduced significantly in treatment group than those in control group（P 0.05）.Conclusions Hemoperfusion is a new approach for adjunctive treatment of Henoch-Schonlein purpura.The elimination of blood inflammatory mediators may be a possible way for hemoperfasion to alleviate clinical symptoms and kidney pathological injuries in Henoch-Schonlein purpura.

关 键 词：血液灌流 过敏性紫癜 儿童 

分 类 号：R725.5[医药卫生—儿科]