黄芪注射液对特发性肾病综合征患儿血清IL-10的影响

Effect of Astragalus for Injection on Serum Level of Interleukin-10 in Children with Idiopathic Nephrotic Syndrome

目的 观察黄芪注射液对特发性肾病综合征（INS）患儿血清白细胞介素10（IL-10）水平的影响。方法 63例未用过糖皮质激素治疗或诊断为INS，但使用糖皮质激素治疗已完全缓解并停用激素〉3个月又复发的INS患儿，随机分为治疗组A33例和治疗组B30例。治疗组A给予泼尼松口服治疗，1．5～2．0mg·kg^-1·d^-1，qd；另加用黄芪注射液0．5mL·kg^-1·d^-1；同时给予利尿、抗感染等对症处理；治疗组B除不给予黄芪注射液外，其他治疗同治疗组A。两组均在INS初发期和治疗1个月后采用双抗体夹心ELISA方法检测血清IL-10水平。另设25例正常儿童为对照组。结果 发病初期，治疗组A和治疗组B血清IL-10水平均较正常对照组高（均P〈0．01）。治疗组B经泼尼松治疗后血清IL-10水平[（9．36±3．43）Pg·mL^-1较治疗前明显降低（P〈0．01），且与正常对照组比较，差异无显著性（P〉0．05）；治疗组A治疗后血清IL-10水平[（12．10±4．14）Pg·mL^-1]与本组治疗前比较，差异无显著性；仍较正常对照组和治疗组B治疗后高，且均差异有显著性（均P〈0．05）。结论 黄芪注射液能防止INS患儿血清IL-10水平降低，能对抗激素对IL-10产生的抑制作用，这可能是黄芪注射液降低INS患儿尿蛋白含量的作用机制之一。

Objective To detect the effect of astragalus for injection together with glucocorticoid on serum levels of IL-10 in children with idiopathic nephrotic syndrome（ INS）, to analyse their role in INS and the mechanism of astragalus＇treatment for INS. Methods Sixty-three children with idiopathic nephrotic syndrome were divided into astragalus group including thirtythree cases and non-astragalus group including thirty cases. In astragalus group, patients were given prednisone 1.5～2.0mg·kg^-1·d^-1 ,P. O. , qd, astragalus for injection 0.5mL·kg^-1·d^-1 , and other symptomatic treatments. In non-astragalus group except astragalus for injection, other treatments were the same as the first group. The serum IL-10 levels in all patients between initial stage and one month after therapy were detected. Other 25 healthy children were collected in control group. Serum IL-10 levels were detected by a double antibody ＂ sandwich＂ ELISA. Results In initial stage, there was no significant difference in serum IL-10 level between non-astragalus group and astragalus group （14.05 ± 5.57） pg · mL^-1 vs （13.39 ± 6.14） pg· mL^-1 （t = 0.61, P 〉 0.05 ）, and both were higher than control group [ （ 14.05 ± 5.57 ）pg · mL^-1 vs （9.48 ± 4.01 ） pg · mL^-1, t=3.36, P〈0.01, and （13.39±6.14） pg · mL^-1 vs （9.48±4.01） pg · mL^-1, t=2.77, P〈0.01]. Serum IL-10 levels in non-astragalus group after prednisone therapy were significantly lower than those before prednisone therapy （9.36 ± 3.43 ） pg · mL^-1 vs （ 14.05 ± 5.57） pg · mL^-1 , t = 3.55, P 〈 0.01, and no significant difference was observed as compared with control group. Compared with those before treatment, Serum IL-10 levels in astragalus group were not significant different in initial stage and one month after prednisone together with astragalus therapy（ t = 0.95, P 〉 0.05. Serum IL-10 levels of astragalus group in one month after prednisone together with astragalus therapy were still significantly higher than those in control group （ 12.10 ±4.14） pg · mL^-1 vs （9.48 ± 4.01 ） pg · mL^-1 , t = 2.25, P 〈 0.05 and non-astragalus group in one month after prednisone therapy（12.10 ±4.14） pg · mL^-1vs （9.36 ±3.43）pg · mL^-1, t =2.40,P 〈0.05）. Conclusion Astragalus for injection can prevent the lowering of serum IL-10 levels in children with idiopathic nephrotic syndrome and counteract the inhibitory effect of hormone on the production of IL-10. This may be one of the mechanism of astragalus for injection to lower the urine protein content in children with INS.