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[急性化脓性肾盂肾炎患者免疫缺陷状态的纠正]

[The correction of immunodeficiency states in patients with acute suppurative pyelonephritis].

作者信息

Buglova S E, Plisan S O

出版信息

Urol Nefrol (Mosk). 1991 Mar-Apr(2):17-21.

PMID:2063497
Abstract

The analysis of the examination findings of 54 patients with purulent pyelonephritis showed a great variety of immunological changes, which appeared both as differences in the types of abnormal immunity parameters and in the degree of the recorded pathological conditions. T-cell immunity deficiency was revealed in 55.6% of the patients, in a half of whom it was associated with humoral factor deficiency. In 25.9% of the patients the immunograms were similar to those in the controls and in 18.5% they were indicative of humoral immunity activation. Supplement of T-activin to the conventional antibacterial therapy contributed to an early immunological and clinical remission. The immunomodulatory effect was associated with the initial immune deficiency and manifested itself by higher relative and absolute T-lymphocyte contents along with elimination of their subpopulation imbalance. The effect proved to be less profound on the humoral immunity system. The arrest of an inflammatory reaction was evidenced by a decrease in beta-lysine levels in the serum up to normal ones. In contrast, antibacterial therapy without immunomodulation deteriorated the abnormal ratios of immunocompetent cells. The findings suggest that it is essential to take an individual approach to the use of immunomodulating therapy in patients with acute purulent pyelonephritis, taking into account not only clinical but immunological indications. It is most advisable to apply T-activin in cases of T-cell immune deficiencies with a significant imbalance of T-lymphocyte populations.

摘要

对54例化脓性肾盂肾炎患者的检查结果分析显示,存在多种免疫变化,这些变化既表现为异常免疫参数类型的差异,也表现为所记录病理状况的程度差异。55.6%的患者存在T细胞免疫缺陷,其中一半与体液因子缺乏有关。25.9%的患者免疫图谱与对照组相似,18.5%的患者免疫图谱表明体液免疫激活。在传统抗菌治疗中补充T-激活素有助于早期免疫和临床缓解。免疫调节作用与初始免疫缺陷相关,表现为相对和绝对T淋巴细胞含量增加以及亚群失衡的消除。该作用在体液免疫系统上的表现不那么明显。血清中β-赖氨酸水平降至正常表明炎症反应得到控制。相反,未进行免疫调节的抗菌治疗会使免疫活性细胞的异常比例恶化。研究结果表明,在急性化脓性肾盂肾炎患者中使用免疫调节治疗时,必须采取个体化方法,不仅要考虑临床指标,还要考虑免疫指标。在T细胞免疫缺陷且T淋巴细胞群体严重失衡的情况下,应用T-激活素最为适宜。

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