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地塞米松和丙种球蛋白联合泼尼松治疗儿童过敏性紫癜肾炎的疗效及对免疫功能的影响。

Effects of dexamethasone and gamma globulin combined with prednisone on the therapeutic effect and immune function of Henoch-Schonlein purpura nephritis in children.

机构信息

Department of Pediatric Surgery, Cangzhou Central Hospital, Cangzhou, China.

出版信息

J Clin Lab Anal. 2021 Jan;35(1):e23580. doi: 10.1002/jcla.23580. Epub 2020 Nov 11.

DOI:10.1002/jcla.23580
PMID:33174652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7843260/
Abstract

BACKGROUND

Henoch-Schonlein purpura nephritis (HSPN) is a serious complication of Henoch-Schonlein purpura (HSP), which is usually treated with immunosuppressant and glucocorticoid. This study was designed to explore the effect of dexamethasone and gamma globulin combined with prednisone in the treatment of pediatric HSPN.

METHODS

According to the treatment plan, 60 children treated with dexamethasone and gamma globulin were included in the control group, and the rest 55 children treated with dexamethasone and gamma globulin combined with prednisone were selected as the research group. The clinical manifestations, therapeutic effect, immune function, serum inflammatory factors, blood coagulation function, urine routine, renal function, and adverse reactions were compared between the two groups.

RESULTS

The clinical manifestations of children in the research group were significantly better than those in the control group after treatment (P < .05). The total effective rate in the research group (94.55%) was markedly higher than that in the control group (76.67%) (P < .05). CD3+, CD4+, CD8+, IL-10, PT, and APTT increased while CD4+/CD8+, IgA, IL-8, TNF-α, FIB, urine protein, urine red blood cell, Scr, and BUN decreased in both groups after treatment, and the changes of all the above indexes in the research group were significant than those in the control group (P < .05). The incidence of adverse reactions in the research group was remarkably superior to that in the control group (P < .05).

CONCLUSION

Dexamethasone and gamma globulin combined with prednisone can improve the immune function of children with HSPN and promote the recovery of renal function.

摘要

背景

过敏性紫癜肾炎(HSPN)是过敏性紫癜(HSP)的严重并发症,通常采用免疫抑制剂和糖皮质激素治疗。本研究旨在探讨地塞米松和丙种球蛋白联合泼尼松治疗儿童 HSPN 的效果。

方法

根据治疗方案,纳入 60 例采用地塞米松和丙种球蛋白治疗的患儿作为对照组,另选取 55 例采用地塞米松和丙种球蛋白联合泼尼松治疗的患儿作为观察组。比较两组患儿的临床表现、治疗效果、免疫功能、血清炎症因子、凝血功能、尿常规、肾功能、不良反应。

结果

观察组患儿治疗后的临床表现明显优于对照组(P<0.05)。观察组总有效率(94.55%)显著高于对照组(76.67%)(P<0.05)。两组患儿治疗后 CD3+、CD4+、CD8+、IL-10、PT、APTT 升高,CD4+/CD8+、IgA、IL-8、TNF-α、FIB、尿蛋白、尿红细胞、Scr、BUN 降低,且观察组变化幅度大于对照组(P<0.05)。观察组不良反应发生率显著优于对照组(P<0.05)。

结论

地塞米松和丙种球蛋白联合泼尼松可改善 HSPN 患儿的免疫功能,促进肾功能恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/d65353a55b80/JCLA-35-e23580-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/39f7f2852256/JCLA-35-e23580-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/9271f5c09925/JCLA-35-e23580-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/eafaa9485bb1/JCLA-35-e23580-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/30d12613d661/JCLA-35-e23580-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/d65353a55b80/JCLA-35-e23580-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/39f7f2852256/JCLA-35-e23580-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/9271f5c09925/JCLA-35-e23580-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/eafaa9485bb1/JCLA-35-e23580-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/30d12613d661/JCLA-35-e23580-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ce/7843260/d65353a55b80/JCLA-35-e23580-g005.jpg

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