槐杞黄颗粒辅助治疗PNS患儿血清IL-21及IFN-γ的变化

Effect of Huaiqihuang on the Change of IL - 21 and IFN - γ in Children with Primary Nephrotic Syndrome

目的:观察原发性肾病综合征(PNS)患儿采用槐杞黄颗粒辅助治疗前后血清白细胞介素-21(IL-21)及干扰素-γ(IFN-γ)的动态变化。方法:2010年6月31日～2011年12月31日收治于中国医科大学附属盛京医院小儿肾脏风湿科的PNS患儿50例,随机分为两组:泼尼松联合槐杞黄颗粒治疗组24例(A组),单纯泼尼松治疗组26例(B组)。观察治疗前和治疗1个月、3个月后外周血中IL-21及IFN-γ的变化。选取健康体检儿童15名为健康对照组(C组)。采用酶联免疫吸附法测定血清中IL-21及IFN-γ的浓度。结果:(1)A、B组IL-21均显著高于C组(P<0.05),治疗1个月后两组IL-21均显著下降,组间差异无统计学意义,至3个月后A组显著降低,并低于B组(P<0.05),仍未达C组水平。(2)A、B组IFN-γ均低于C组(P<0.05),治疗1个月后两组IFN-γ显著升高,组间差异无统计学意义,至3个月后A组显著升高,并高于B组(P<0.05),接近C组水平。结论:PNS患儿治疗前IL-21的升高和IFN-γ的降低可能参与PNS的发病,槐杞黄辅助治疗可以下调肾病患儿IL-21的表达,上调IFN-γ的表达,纠正Th1/Th2失衡,从而发挥免疫调节作用。

Objective： To observe the dynamic changes of serum leukocyte interleukin- 21 （IL -21 ） and interferon -γ （IFN -gamma） in children with primary nephrotic syndrome（PNS） at pre -and post -treatment assist with huaiqihuang particles. Methods：The study cohort consisted of 50 children with PNS who were randomly divided into group A （24 cases） and group B （26 cases）. Group A was treated with prednisone and huaiqihuang particles, while group B only was treated with prednisane. 15 healthy children were studied as the healthy control group （group C）. Observe the serum IL -21 and interferon -γlevel before the treat- ment, 1 month and 3 months after treatment. Serum IL - 21 and interferon - γ was tested by enzyme linked immunosorbent assay. Re- sults：1 ）Before treatment, the serum level of IL- 21 of Group A and B was significantly higher than group C （P 〈 0.05）, 1 months after treatment the two groups were significantly decreased, there were no differences between the two groups, After 3 months, group A was significantly reduced, and lower than group B （P 〈 0.05）, but still did not reach the level of group C. 2） Before treatment, IFN - γ of Group A and B were lower than group C （P 〈 0.05）, 1 months after treatment the two groups were increased, there were no differences between the two groups, After 3 months, group A was significantly increased, and higher than group B （ P 〈 0.05 ）, close to the level of group C. Conclusion：The increased of IL -21 and decreased of IFN -γ may play an important role in the patho- genesis of PNS. The adjuvant therapy of Huaiqihuang can downregulate secretion of IL -21 and upregulate secretion of IFN -γ, regu- late Th1/Th2 balance, and it plays an important role in immunomodulatory effects