槐杞黄颗粒辅助波尼松治疗PNS患儿效果及对免疫功能、外周血NGAL、KIM-1、L-FABP水平的影响

Effects of Huaiqihuang Granule Supplemented with Prednisone on Children Patients with PNS and its Influence on Immune Function and Levels of Peripheral Blood NGAL,KIM-1 and L-FABP

目的:探讨槐杞黄颗粒辅助波尼松治疗原发性肾病综合征(PNS)患儿效果及对免疫功能的影响。方法:选取2016年06月~2018年06月我院收治的152例PNS患儿为研究对象,用随机数字表法分为观察组和对照组各76例。观察组患儿予以槐杞黄颗粒+波尼松治疗,对照组患儿仅予以泼尼松治疗。比较两组患儿水肿消退、尿蛋白转阴时间以及治疗期间感染率、复发率,观察治疗前后血清免疫球蛋白(IgA、IgG、IgM)、T、B淋巴细胞亚群(CD+3、CD+4、CD+8、CD+4/CD+8、NK细胞)、血清中性粒细胞明胶酶相关载脂蛋白(NGAL)、肾损伤分子-1(KIM-1)、肝型脂肪酸结合蛋白(L-FABP)等外周血指标变化情况。结果:观察组患儿水肿消退时间、尿蛋白转阴时间均短于对照组,感染率和复发率均低于对照组(P<0.05);治疗6个月后,两组患儿血清中IgG较治疗前升高,且观察组高于对照组(P<0.05),血清IgM以及NGAL、KIM-1、L-FABP水平较治疗前降低,且观察组低于对照组(P<0.05);两组患儿外周血CD+3、NK细胞水平均较治疗前升高,且观察组高于对照组(P<0.05),观察组患儿CD+4、CD+4/CD+8水平均较治疗前升高,且高于对照组(P<0.05)。结论:槐杞黄颗粒联合波尼松治疗PNS可有效缓解临床症状,减少感染和复发,长期使用可改善患儿体液免疫和细胞免疫,减轻肾脏损伤。

Objective:To explore the effects of Huaiqihuang granule supplemented with prednisone in the treatment of children patients with primary nephrotic syndrome(PNS)and its influence on immune function.Methods:A total of 152 children patients with PNS admitted to our hospital from June2016 to June2018 were selected for the study and were divided into observation group and control group according to the random number table method,with 76 cases in each group.Observation group was given Huaiqihuang granule+prednisone,and control group was only treated with prednisone.The edema regression time,time of urinary protein negative conversion and the infection rate and recurrence rate during treatment were compared between the two groups.Serum immunoglobulins(IgA,IgG,IgM),T and B lymphocyte subsets(CD+3,CD+4,CD+8,CD+4/CD+8,NK cells),serum neutrophil gelatinase-associated lipoprotein(NGAL),kidney injury molecule-1(KIM-1),liver fatty acid binding protein(L-FABP)and other peripheral blood indexes were observed before and after treatment.Results:The edema regression time and time of urinary protein negative conversion in observation group were shorter than those in control group,and the infection rate and recurrence rate were lower than those in control group(P<0.05).After 6 months of treatment,the serum IgG level in the two groups was increased compared with that before treatment,and the level in observation group was higher than that in control group(P<0.05),and the levels of serum IgM and NGAL,KIM-1 and L-FABP were decreased compared with those before treatment,and the levels in observation group were lower than those in control group(P<0.05).The levels of peripheral blood CD+3 and NK cells in the two groups were increased compared with those before treatment,and the levels in observation group were higher than those in control group(P<0.05).The levels of CD+4 and CD+4/CD+8 in observation group were increased compared with those before treatment,and were higher than those in control group(P<0.05).Conclusion:Huaiqihuang granule combined with prednisone can effectively alleviate clinical symptoms and reduce infection and recurrence.Long-term use can improve humoral immunity and cellular immunity and reduce kidney injury.