槐杞黄对紫癜性肾炎患儿Th17／Treg细胞免疫失衡的调节作用  

Balance of regulation of Th17/Treg in children with Henoch-Schoenlein purpura nephritis using Huaiqihuang

作　　者：周杜鹃[1] 吴小川[1] 王复娟[1] 易著文[1] 曹艳[1] 黄丹琳[1] 何庆南[1] 党西强[1] 

机构地区：[1]中南大学湘雅二医院小儿肾脏病研究室,长沙410011

出　　处：《中华实用儿科临床杂志》2013年第5期352-356,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的观察紫癜性肾炎（HSPN）患儿外周血Th17细胞及其相关因子IL-17和Treg细胞的水平，探讨槐杞黄在调节HSPN患儿Th17／Treg细胞失衡及改善临床症状方面的作用。方法将研究对象分为过敏性紫癜（HSP）组10例，HSPN组30例，健康对照组11例。健康对照组抽取外周血采用ELISA法检测IL-17水平，流式细胞术检测Th17和CD4＋CD＋Treg细胞数。HSP组和HSPN组在急性发作时、治疗前抽血检测IL-17水平、Th17和CD4＋CD＋Treg细胞数，HSPN组留尿检测24h尿蛋白和尿沉渣。HSPN组病理检查为Ⅱ级的患儿20例按随机数字法分为常规治疗组和槐杞黄治疗组；将病理检查为ma级的患儿10例按随机数字法分为泼尼松治疗组和泼尼松＋槐杞黄治疗组。常规治疗组予口服福辛普利和双嘧达莫治疗。槐杞黄治疗组予常规治疗并口服槐杞黄颗粒。泼尼松治疗组予常规治疗并口服泼尼松。泼尼松＋槐杞黄治疗组予常规治疗、泼尼松和槐杞黄颗粒口服治疗。2个月后抽血检测外周血IL-17水平、Th17和CD4＋CD25＋Treg细胞数，留尿检测24h尿蛋白和尿沉渣。结果HSP组和HSPN组患儿外周血Th17细胞数及IL-17水平较健康对照组明显增高（P均〈0．05），Treg细胞水平较健康对照组明显降低（P〈0．05），但HSPN组患儿Th17、rrreg细胞数和IL-17水平与HSP组患儿比较差异无统计学意义（P〉0．05）。常规治疗组治疗后Th17细胞数、IL-17水平、尿沉渣红细胞较治疗前有所下降，Treg细胞数较治疗前有所升高，但差异均无统计学意义（P均〉0．05）；24h尿蛋白较治疗前明显下降（P〈0．05）。槐杞黄治疗组治疗后Th17细胞数、IL-17水平、24h尿蛋白、尿沉渣红细胞较治疗前和常规治疗组明显下降（P均〈0．05），而Treg细胞数较治疗前和常规治疗组明显增高（P均〈0．05）。泼尼松治疗组治疗后Th17细胞数、IL—17水平、24h尿蛋白、尿沉渣红细�Objective To observe the levels of Thl7 and associated cytokine IL-17 and Treg in peripheral blood in children with Henoch-Schonlein purpura nephritis （HSPN） , and to explore the balance of regulation of Th17/ Treg and the function of improvement of clinical symptoms in children with HSPN by using Huaiqihuang. Methods The objects were divided into 3 groups ： healthy control group （ n = 11 ）, Henoch-Schonlein purpura （HSP） group （ n = 10 ） and HSPN group （n = 30）. Healthy children were measured for the level of IL-17 by enzyme-linked immunosorbent assay（ELISA） and the circulating frequencies of Thl7 and CD4＋ CDz5 ~ Treg cells by flow cytometry （FCM）. HSP group and HSPN group were measured for the levels of IL-17, Thl7 cells and Treg cells when illness had acute attack and had not used any drugs. Furthermore, HSPN group was measured for 24-hour urine proteins and urinary sediment red blood cells（RBCs）. Patients in HSPN group with the pathological grading l] were divided into conventional therapy group（ n = 10） and Huaiqihuang group（ n = 10） randomly. Patients in HSPN group with the pathological grading ]]Ia were divided into Prednisone group（ n = 5 ） and Prednisone ＋ Huaiqihuang group（ n = 5 ） randomly. Conventional thera- py group was treated with oral Fosinopril and Dipyridamole. Huaiqihuang group was treated with conventional therapy and oral Huaiqihuang particles. Prednisone group was treated with conventional therapy and oral Prednisone. Prednisone ＋ Huaiqihuang group was treated with conventional therapy, Prednisone and Huaiqihuang particles. After 2 months of treatments,the levels of IL-17, Th17 cells, Treg ceils,24-hour urine proteins and urinary sediment RBCs were mea- sured. Results The circulating frequencies of Th17 cells and IL-17 in HSP group and HSPN group were higher than those in healthy control group（ all P 〈 0.05 ） , while the circulating frequencies of Treg ceils were lower than those in heahhy control group（ all P 〈 0.05 ）, but

关 键 词：紫癜性肾炎 Th17 TREG 槐杞黄 

分 类 号：R726[医药卫生—儿科]