皮质类固醇激素及免疫抑制剂对过敏性紫癜肾炎患儿的影响

Effect of corticosteroid and immunosuppressor for children with henoch-schonlein purpura nephritis

目的探讨过敏性紫癜肾炎患儿采用皮质类固醇激素及免疫抑制剂治疗对血清白介素16(IL-16)和白介素18(IL-18)水平的影响及临床价值。方法选取50例过敏性紫癜肾炎患儿作为研究对象,根据不同治疗方式随机分为2组,常规治疗组采用常规治疗,联合治疗组采用皮质类固醇激素及免疫抑制剂治疗,另选取25例查体健康儿童作为健康对照组,采用酶联免疫吸附剂测定法检测研究对象的血清IL-16和IL-18水平。结果治疗前,常规治疗组、联合治疗组血清IL-16、IL-18水平对比,差异无统计学意义(P>0.05);治疗后,联合治疗组血清IL-16、IL-18水平均低于常规治疗组(P<0.05);联合治疗组急性期与缓解期血清IL-16、IL-18水平均高于健康对照组(P<0.05),急性期血清IL-16、IL-18水平高于缓解期(P<0.05)。结论血清IL-16、IL-18可能参与过敏性紫癜肾炎的发病过程,临床采用皮质类固醇激素及免疫抑制剂治疗可能通过抑制IL-16、IL-18水平而发挥治疗作用,血清IL-16、IL-18水平对过敏性紫癜肾炎患儿病情发展的判断具有一定价值。

Objective To explore effect of corticosteroid and immunosuppressor for children with henoch-sehonlein purpura nephritis on serum intedeukin 16 （IL-16） and intedeukin 18 （IL-18） and its clinical value. Methods A total of 50 children with henoeh-sehonlein purpura nephritis in our hospital were as research objects, and were randomly divided into routine treatment group and combined treatment group according to the treatment methods, given cortieosteroid and immunosup- pressive therapy. And another 25 healthy children were as healthy controls. Serum IL-16 and IL-18 levels were detected using enzyme linked immunosorbent assay method. Results Before treatment, the conventional treatment group, and combined treatment group had no significant differences in ser- um IL-16, IL-18 levels （P 〉 0.05）. After treatment, combined treatment group had lower serum IL-16, IL-18 levels than the conventional treatment group （P 〈 0.05）. Combined treatment group had higher serum IL-16, IL-18 levels in acute stage and remission period than the healthy controls （P 〈 0.05 ）. Serum IL-16 and IL-18 levels in acute stage were higher than the remission period（P 〈 0.05 ）. Conclusion Serum IL-16 and IL-18 may be involved in the pathogenesis of henoch-sehonlein purpura nephritis, corticosteroids and immunosuppressive therapy may inhibit the levels of IL-18 and IL-16, and their levels has a certain value in diagnosis of henoch-schonlein purpura nephritis in children.