卡介菌多糖核酸治疗春季结膜炎30例

BCG-PSN on the Treatment of 30 Patients with Spring Conjunctivitis

目的观察卡介菌多糖核酸(BCG-PSN)治疗春季结膜炎的疗效与该药对患者T细胞亚群及细胞因子水平的影响。方法60例春季结膜炎患者,随机分成两组。治疗组30例给予BCG-PSN肌内注射,每次1(>13岁者)或0.5 mg(≤13岁者),每周3次,4周为1个疗程,共两个疗程,同时进行常规治疗,即给予2%色甘酸滴眼液和0.5%醋酸可的松滴眼液滴双眼;对照组30例只给予常规治疗。测定治疗前后两组患者的总IgE水平,间接免疫荧光法检测外周血T细胞亚群及细胞因子水平,ELISA法检测血清白细胞介素4(IL-4)和γ干扰素(INF-γ)含量。结果治疗组总有效率(96.7%)明显高于对照组(70.0%),且差异有极显著性(P<0.01)。治疗组治疗后总IgE水平显著降低(P<0.01),CD8+T细胞下降,CD4+T细胞及CD4+/CD8+值升高,与治疗前比较均差异有显著性(均P<0.05);对照组以上指标无明显变化。结论BCG-PSN具有双向免疫调节作用,能协调CD4+、CD8+T细胞的动态平衡,防止变态反应的发生,同时能抑制Th2型细胞,减少IL-4合成,使Th1/Th2平衡向Th1方向转换,Th1细胞优势相对增强,有利于春季结膜炎病情的长期稳定和恢复。

Objective To observe the clinical effect of BCG-PSN on conjunctivitis in spring and on serum levels of T cell subsets and of cytokines. Method 60 patients with conjunctivitis were equally randomized into two groups. The treatment group were given BCG-PSN 1 （ 〉 13 a） or 0, 5 mg（≤ 13 a） , im, three times a week for 8 weeks besides the conventional treatment. The control group was treated conventionally. The levels of total IgE, of T-cell subsets and cytokines were determined before and after treatment. IL-4 and INF-γ were determined by ELISA. Results The levels of total IgE in treatment group were significantly lower than that of the control group （ P 〈 0.01 ） after the treatment. And the levels of CD8^＋ were lower, meanwhile, the levels of CD4^＋ and of CD4^＋/CD8^＋ were much higher, significandy （P 〈 0.05 ）. And the level of IL-4 were significantly lower, and levels of INF-γ higher （ P 〈 0. 05 ）. Conehlsion BCG-PSN can regulate immunity function, coordinate the homeostasis of CD4^＋ and CD8^＋ cells, and reduce the occurrence of anaphylaxis. BCG-PSN may inhibit the Th2 and reduce the synthesis of IL-4, and strongthenThl. BCG-PSN can help the recovery of conjunctivitis in spring.