雷公藤多苷对紫癜性肾炎患儿炎症及免疫功能的影响

摘要

Objective To investigate the effects of conventional therapy combined with tripterygium glycosides on interleukin 10(IL-10),chemokine ligand 9(CXCL9),transforming growth factor β1(TGF-β1)and immunoglobulin A(IgA)levels in children with anaphylactic purpura nephritis.Methods Clinical data of 120 cases of children with anaphylactic purpura nephritis in General Hospital of Jinan from June 2015 to December 2016 were retrospectively analyzed.The cases were divided into experimental group (n=60)and control group(n=60)according to medication.Two groups were treated with conventional therapy,and tripterygium glycosides tablets was additionally given to the experimental group.The levels of IL-10,CXCL9,TGF-β1and IgA were compared between two groups before and after treatment.Results Compared with the control group,the total effective rate was significantly higher(χ2=10.21,P<0.01)and the incidence of adverse reactions was lower(χ2=4.66,P=0.03)in the experimental group with significant differences.Before treatment,there was no significant difference between two groups in related indexes(P> 0.05). After treatment,the levels of IgA,IgG,CXCL9 and TGF-β1in two groups were significantly lower than those in the same group before treatment,and the level of IL-10 was significantly higher than that of the same group before treatment.Compared with the control group,the levels of IgA(t=13.44,P<0.01),CXCL9(t=39.64,P<0.01)and TGF-β1(t=29.55,P<0.01)in the experimental group were significantly lower,while the level of IL-10(t=2.79,P<0.01)was significantly higher.The differences were statistically significant.There were no significant differences in the levels of IgG,IgM and MMP-9 between two groups after treatment.IgA was negatively correlated with IL-10(r=-0.64,P<0.01)but positively correlated with CXCL9(r=0.43,P<0. 01)and TGF-β1(r = 0.35,P < 0.01)levels.Conclusion Conventional therapy combined with tripterygium glycosides can significantly improve the level of inflammation and immune factors in children with anaphylactic purpura nephritis.%目的 探讨常规治疗联合雷公藤多苷对紫癜性肾炎患儿白细胞介素-10(IL-10)、趋化因子9(CXCL9)、转化生长因子-β1(TGF-β1)和免疫球蛋白A(IgA)的影响.方法 选取济南军区总医院于2015年6月至2016年12月收治的120例紫癜性肾炎患儿的临床资料进行回顾性分析,根据用药不同分为实验组(60例)和对照组(60例).两组患儿均给予常规治疗,此外,实验组患儿给予雷公藤多苷片.比较两组患儿治疗前后IL-10、CXCL9、TGF-β1及IgA水平.结果 与对照组相比,实验组的总有效率明显较高(χ2=10.21,P<0.01),而不良反应发生率明显较低(χ2=4.66,P=0.03),差异有统计学意义.治疗前,两组患儿各项相关指标组间比较均无统计学差异(P>0.05).治疗后,两组患儿IgA、IgG、CXCL9、TGF-β1水平均明显低于同组治疗前,而IL-10水平明显高于同组治疗前,且与对照组相比,实验组的IgA(t=13.44,P<0.01)、CXCL9(t=39.64,P<0.01)、TGF-β1(t=29.55,P<0.01)水平均明显较低,而IL-10(t=2.79,P<0.01)水平明显较高,差异具有统计学意义;两组治疗后IgG、IgM、基质金属蛋白酶9(MMP-9)水平组间比较均无显著性差异.IgA与IL-10水平呈负相关(r=-0.64,P<0.01),与CXCL9(r=0.43,P<0.00)、TGF-β1(r=0.35,P<0.01)水平呈正相关.结论 常规治疗联合雷公藤多苷可明显改善紫癜性肾炎患儿的炎症及免疫因子水平.