匹多莫德预防过敏性紫癜复发效果及其对免疫功能的影响

摘要

Objective To explore the effect of Pidotimod in preventing the relapse of Henoch-Schonlein purpura (HSP) and the inpact on immune function. Methods From January 2005 to December 2010, 76 children with HSP were randomly divided into Pidotimod therapy group (n = 40) and general therapy group (n = 36). Two groups were all treated by routine medicine. In addition, Pidotimod was given to Pidotimod therapy group. The antigen markers of T-lymphocyte, including CD3, CD4 and CDS expression on the surface of peripheral blood lymphocytes were analyzed by flow cytometry, the serum levels of IgA, IgG and IgM were detected by immunol nephelometer before and after 3 months treatment. And 15 cases of healthy children were selected as normal control group. The relapse rate was recorded within 6 months and 1 year after course of treatment. The changes of immune globulin and T-lymphocyte subsets between HSP group and normal control group, Pidotimod therapy group and general therapy group were compared. Results The relapse rate in Pidotimod therapy group was significantly lower than that of general therapy group (P < 0.05). The level of CD3, CD4, CD8, CD4/CD8, IgG, IgA and IgM between the two groups before trentment had no significant difference (P > 0.05). But the level of CD3, CD4 cell, ratio of CD4/CD8 cell in HSP group were significantly lower than those in normal control group (P < 0.01), and the serum concentration of IgA in HSP group was significantly higher than that in normal control group (P < 0.01). After treatment by Pidotimod, the level of CD3, CD4 and ratio of CD4/CD8 in Pidotimod therapy group were significantly higher than those in general therapy group (P < 0.01), meanwhile IgA in Pidotimod therapy group was was significantly lower than that in general therapy group (P < 0.05). Conclusion Pidotimod is effective for prevention of relapse of HSP. Its mechanism is related to accelerating the recovery of HSP immune abnormality.%目的 探讨匹多莫德预防过敏性紫癜(HSP)复发的疗效及其对免疫功能的影响.方法 选取2005年1月～2010年12月在我院确诊的过敏性紫癜患儿76例作为研究对象,将其随机分为匹多莫德组(n=40)和一般治疗组(n=36).两组患儿均采用常规治疗,在此基础上,匹多莫德组加用匹多莫德口服.同时检测HSP患儿治疗前和治疗3个月后外周血T淋巴细胞亚群CD3、CD4、CD8、CD4/CD8及免疫球蛋白IgG、IgA、IgM水平,另取15例正常儿童作为治疗前的健康对照组.观察两组HSP患儿在6个月和1年内的复发情况,并比较HSP患儿与健康儿童外周血免疫功能的变化及匹多莫德组和一般治疗组治疗后的免疫功能变化.结果 匹多莫德组在治疗后6个月及1年内复发率均低于一般治疗组,两组比较差异有统计学意义(P＜0.05).治疗前两组HSP患儿外周血CD3、CD4、CD8、CD4/CD8、IgG、IgA、IgM比较,差异均无统计学意义(P＞0.05),但CD3、CD4及CD4/CD8低于健康对照组(P＜0.01),IgA高于健康对照组(P＜0.01).匹多莫德组经匹多莫德治疗后,CD3、CD4、CD4/CD8明显高于一般治疗组,且差异有统计学意义(P＜0.01),而IgA低于一般治疗组,差异有统计学意义(P＜o.05).结论 匹多莫德对预防过敏性紫癜复发有一定的疗效,其机制可能与促进过敏性紫癜免疫异常恢复有关.