短期应用肾上腺皮质激素对细胞免疫功能影响的实验与临床研究

Effects of Short Term Application of Cortico-steroids on Function of Cellular Immunity:An Experimental and Clinical Study

【目的】通过实验与临床研究评价短期应用肾上腺皮质激素对细胞免疫功能的影响。【方法】把 40只小鼠分为两组,第1组10只为正常对照组,第2组30只服强地松30mg/kg-1·d-1,连服7d,并分别于 d3、d7、d10、d14、d21、d30日各处死5只,检测血中淋巴细胞亚群和血、胸腺、脾脏淋巴细胞凋亡率。对30例上感 高热患儿在用病毒唑或抗生素同时静滴地塞米松0.2～0.4mg/kg,一次/d,连用3d。【结果】服激素组与正 常对照组无差别。体温3d内均降至正常,3d后检测血中淋巴细胞亚群,均在正常范围内。随访7d,无任何 并发症。【结论】上感高热患儿短期使用激素,可使体温稳步下降,且较持久,而对细胞免疫无不良影响。

ObjectiveTo evaluate the effects of short term application of cortico-steroids on function of cellular immunity through experimental and clinical study.Forty mice were divided into two groups: ① Group of normal control,10 mice were included; ② Group of hormone therapy, prednisone 30mg/kg. per day was fed P.O. in 30 mice for 7 days and each 5 mice were killed at 3rd ,7th, 10th, 14th,21st and 30th day, respectively.. Lymphocyte subsets in the blood and the apoptotic rate of lymphocytes in blood , thymus and spleen were detected. Excepting virazole or antibiotics, simultaneous iv. infusion of dexamethasone 0.2~0.4 mg/kg per day for 3 days was scheduled in 30 cases of upper respiratory tract(URT) infection with high fever.There were no significant differences in the items mentioned above between mice of normal control group and hormone therapy group. Fever in URT patients became normal within 3 days. Lymphocyte subsets were all within normal range after treatment for 3 days. No any complication was found during follow-up for 7 days.[Conclusion] Short term cortico-steroids therapy can be used for infection of URT with high fever. It declines body temperature steadily and shows more persistent action. No adverse effect on cellular immunity has been observed.