血液灌流治疗儿童过敏性紫癜疗效及对免疫功能的影响

Curative effect of hemoperfusion on Henoch Schonlein purpura in children and its influence on immune function

目的:研究血液灌流治疗儿童过敏性紫癜(HSP)疗效及对免疫功能的影响。方法:选取2015年3月至2017年3月医院收治的160例过敏性紫癜(HSP)患儿为研究对象,随机将其分为观察组(实施常规治疗+血液灌流,n=80)与对照组(实施常规治疗,n=80),观察两组临床症状缓解时间与住院时间,比较两组治疗前后血清免疫因子水平。结果:观察组患儿皮肤紫癜、腹痛、便血、关节疼痛缓解时间与住院时间分别为[(6.4±1.3)d,(3.3±0.8)d,(2.6±0.5)d,(3.6±0.9)d,(10.5±2.4)d]均短于对照组的[(8.8±2.1)d,(5.4±1.2)d,(4.3±1.0)d,(5.7±1.2)d,(13.4±2.6)d],差异具有统计学意义(P<0.05);治疗后两组血清免疫因子免疫球蛋白A(IgA)、免疫球蛋白E(IgE)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平水平较治疗前均降低(P<0.05),且观察组患儿各指标下降幅度均大于对照组(P<0.05);观察组、对照组治疗满意度分别为(95.00%,81.25%,P<0.05)。结论:血液灌流可快速缓解儿童过敏性紫癜临床症状,缩短患儿治疗时间,有效清除患儿体内炎性介质、免疫复合物,提高治疗满意度,值得临床推广。

Objective:To study the curative effect of hemoperfusion on Henoch Schonlein purpura(HSP)in children and its influence on immune function.Methods:160 children with HSP hospitalized from March 2015 to March 2017 were chosen and randomly divided into the observation group(treated by routine therapy and hemoperfusion,n=80)and the control group(treated by routine therapy,n=80),with the remission time of clinical symptom and hospitalization time observed,and levels of serum immune factors compared before and after treatment.Results:The remission time of skin purpura,abdominal pain,hematochezia,joint pain and hospitalization time in the observation group were(6.4±1.3)d,(3.3±0.8)d,(2.6±0.5)d,(3.6±0.9)d,(10.5±2.4)d respectively,which were significantly shorter than those in the control group[(8.8±2.1)d,(5.4±1.2)d,(4.3±1.0)d,(5.7±1.2)d,(13.4±2.6)d respectively](P<0.05).After treatment,levels of serum immune factors immunoglobulin A(IgA),immunoglobulin E(IgE),C reactive protein(CRP),tumor necrosis factorα(TNF-α)and interleukin-6(IL-6)were all significantly decreased in the two groups,and the decreased ranges of different indexes in the observation group were greater than those in the control group(P<0.05).The treatment satisfaction rates of the observation group and the control group were 95.00%and 81.25%respectively(P<0.05).Conclusion:Hemoperfusion can quickly relieve clinical symptoms of HSP in children,shorten the treatment time,effectively remove inflammatory mediators and immune complexes,and improve the satisfaction rate,worthy of clinical promotion.